ESWL (Extracorporeal Shock Wave Lithotripsy) is a procedure where sound waves are used to fragment stones in the kidney and the ureter. These fragments are then passed in the urine.


Which stones can be treated with this procedure?

This procedure is ideally suited for stones less than 1.5 cms in size. A larger stone than this does not respond well to this therapy because of incomplete fragmentation.


Which stones are not suitable for this procedure?

Stones larger than 1.5 cms do not fragment well. Also, stones that are hard respond poorly to this procedure. The hardness of the stone can be assessed by looking at the stone density on x-ray and more accurately by CT scan. Stones that are completely blocking the urinary tract are not suited for this procedure. Stones with infections in the urinary tract should not be treated unless the infection is controlled.


How is this procedure done?

Preliminary tests are done including ultrasound and sometimes x-ray and CT scan. The patient is made to lie down on a table which is attached to the ESWL machine. The machine generates shock waves which pass through the patient’s body and converge on the stone and break it. The stone fragments are then passed in the urine over a period of 2-4 weeks. Each session of ESWL takes about 30-40 minutes. At the end of the procedure, the urologist assesses the fragmentation of the stone and decides whether a 2nd session is needed. If a second session is needed, it is usually done after 2 weeks.


Is the procedure done under anesthesia?

Anesthesia is not given as it is a painless procedure. If mild pain is experienced painkiller injection is given. This procedure does not need hospitalization. Essentially it is a no-touch technique to treat kidney stones. The patient can go home immediately after the procedure.


What are the complications of the procedure?

The stone fragments may cause pain while passing in urine. Pain killers are given to relieve the pain. Sometimes the procedure can result in fever especially if the patient has a urine infection before the procedure. Antibiotics are given in such conditions. Other than these there are no significant complications of this procedure.


What is the approximate cost of this procedure?

It costs about Rs.25000-30000 for the procedure. This includes 2 sessions in case the first one fails to clear the stone. However, if there is no clearance of the stone even after the 2nd session, it is advisable to change to an alternative treatment modality like endoscopy.

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