Extracorporeal shock wave lithotripsy (ESWL) or lithotripsy for short, is a commonly used non-invasive alternative to surgery for the treatment of kidney stones.
The procedure is done under sedation or anaesthetic on the lithotripsy bus. It works by focusing high energy acoustic pulses that pass through the skin and disintegrate the stones. The sand-like fragments can then pass out of the body in urine.
While the vast majority of stones in the urinary tract can be treated successfully with lithotripsy, some are resistant to this method and may require a repeat or alternative treatment.
Lithotripsy has the advantage of typically a much faster recovery than conventional stone surgery.
Before your operation
The operation and outcomes will be explained to you by your urologist. When you feel comfortable that you understand what is to be done and have had all your questions answered, you will be asked to sign a consent form. This consent form should be signed by both yourself and your surgeon and forwarded to the hospital at least five days prior to your admission.
If you are over 60, or have other medical conditions, you may also need an electrocardiogram (ECG) to check the health of your heart prior to surgery.
You will be required to come to the hospital approximately two hours prior to your treatment. This will be confirmed by the hospital the day before your admission.
On arrival you will be taken through pre-admission requirements and shown to your room.
An x-ray of your abdomen may be performed to check the location of the stone.
When it is time for treatment a nurse will escort you from the ward to the Lithotripsy bus which is set up outside the hospital, where you will meet the urologist.
After lying down on the lithotripsy table, a drip is inserted into a vein in your arm. Through this drip the anaesthetist can give you sedation medicine and pain relief during the treatment depending on your individual requirements.
You will be positioned so that you are in the ideal place for treatment. A rubber pad covered with a special gel is placed against the skin. Using ultrasound or x-ray guidance, the shock waves are focused on the stone and treatment will begin.
The lithotripsy machine makes a sound like a hammer tapping.
The treatment normally lasts between 1 to 1.5 hours. At the end of the treatment you will be transferred to a wheelchair and taken to the ward for recovery.
You will go to day surgery area after the procedure. Once able, you will be encouraged to drink plenty of fluid to assist flushing out the stone fragments.
It is common to have a little nausea immediately following the treatment but this is usually resolved by the time of discharge.
After a period of observation you will be discharged home. Some cases may require an overnight stay. Usually work and other normal activities may be resumed the following day if you feel able. You can discuss this with your urologist.
You may eat and drink normally following this treatment and it is important to keep up a good fluid intake.
Stone fragments will pass out of the body into the urine. Occasionally this can cause discomfort and pain as they travel out. You will be given a prescription for pain relief in case this happens.
You will receive a follow-up appointment to see your specialist at six weeks to discuss the results of your treatment. Prior to this you will have an x-ray to check the stone has passed.
Seek immediate advice from Urology Associates or the on call urologist if you develop high fevers and pain. You may have developed an infection following lithotripsy treatment.
Some blood in the urine can occur after this treatment.
Seek prompt advice from Urology Associates or your GP if you experience difficulty urinating or the blood in your urine does not resolve.
There is often bruising or a mild graze on the skin where the shock waves have passed through the body. There may be some bruising to the kidney which can be painful.
There is a chance that lithotripsy may not be successful in breaking up a stone on the first attempt. If the stone is not fully treated, a second lithotripsy may be recommended. Alternatively a surgical option may be explored if it is decided that further lithotripsy is unlikely to help. Your urologist will discuss these options with you.