Know What is ESWL

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Know What is ESWL
Know What is ESWL

ESWL (extracorporeal shock wave lithotripsy) is a procedure to treat kidney stones using shock waves. Through ESWL, kidney stones can be removed without surgery (non-invasive)

ESWL uses a device that emits shock waves. These shock waves are concentrated around the kidneys to break the kidney stones into smaller pieces, so they can be excreted in the urine.

Know What is ESWL - Alodokter

ESWL is effective in destroying kidney stones that are less than 2 cm in diameter. If the kidney stone is more than 2 cm in diameter, the patient will be advised to undergo another procedure.

ESWL Indication

As mentioned above, the ESWL procedure is used to treat kidney stones. Kidney stones are formed from mineral compounds that accumulate in the kidneys in the long term. There are several factors that can increase a person's risk of developing kidney stones, namely:

  • Being overweight or obese
  • Has a family history of kidney stones
  • Dehydrated due to not drinking enough water
  • Consuming foods with excessive levels of protein, s alt, and sugar
  • Has impaired absorption of water and calcium which can be caused by inflammatory bowel disease, chronic diarrhea, and a history of gastric surgery
  • Suffering from hyperparathyroidism or recurrent urinary tract infections

ESWL Alert

Before undergoing the ESWL procedure, there are several things you should know, namely:

  • ESWL is not recommended for pregnant women, people with urinary tract infections, kidney deformities, kidney cancer, abdominal aortic aneurysm, blood clotting disorders, and uncontrolled hypertension.
  • ESWL is not effective in obese patients.
  • ESWL is also not effective in treating kidney stones larger than 2 cm.
  • ESWL is not recommended for patients who are taking blood thinners, such as aspirin or warfarin.
  • ESWL is not recommended for patients with pacemakers, as it can damage the implants implanted in the organ.

Before ESWL

Before undergoing ESWL, patients are advised to consult their doctor first. In the consultation session, the doctor will ask about the patient's medical history and the results of previous kidney stone examinations. Therefore, the patient must bring the results of the scans that have been carried out, be it X-rays, CT scans, or MRIs.

The doctor will also ask about medicines, supplements, and herbal products that are being consumed. If the patient is taking blood thinners, the doctor will advise the patient to stop taking the drug a week before undergoing ESWL.

About 2–3 hours before the ESWL examination, the doctor will examine the patient's urine sample to ensure that the patient does not have a urinary tract infection. If the results of the examination show that the patient has a urinary tract infection, the doctor will postpone ESWL until the patient recovers.

ESWL Procedure

Before the ESWL procedure is performed, the doctor will ask the patient to change into a medical gown. The doctor will also give you painkillers and sedatives. After that, the ESWL procedure will be carried out with the following steps:

  • The doctor will ask the patient to lie down on the bed, then a pillow filled with water will be placed on the back of the kidney where there is a stone. The patient will be positioned in such a way that the shock wave hits the kidney stone.
  • The doctor can give local, regional, or general anesthesia so that the patient does not feel pain during the ESWL procedure. After the anesthesia works, the doctor will determine the location of the kidney stones using ultrasound or X-rays.
  • Once the location of the kidney stone is confirmed, the ESWL machine will send 1,000–2,000 shock waves. The goal is to break the kidney stones into smaller pieces, so they can be excreted in the urine.
  • In some cases, the doctor will perform a stenting technique, which is to insert a special tube (DJ stent) from the urinary opening to the kidney before ESWL begins. This technique is used when the patient experiences severe pain due to blockage of stones in the urinary tract (ureter) and there is a risk of urinary tract infection.

The entire ESWL procedure generally takes 45–60 minutes.

After ESWL Procedure

Patients will usually be asked to rest for 2 hours in the recovery room before going home. However, under certain conditions, the doctor will advise the patient to stay in the hospital until the condition is completely recovered.

Patients who are allowed to go home are encouraged to rest for 1-2 days and drink more water. By drinking lots of water, you will urinate more often, thus helping the elimination of kidney stone fragments through urine.

ESWL Complications

ESWL is a safe procedure. However, in some cases, ESWL can cause complications such as:

  • bruising and discomfort in the area where ESWL was performed
  • Bleeding in the kidney that requires blood transfusion
  • Disorder of kidney function
  • Pain when urinating
  • Urine contains blood
  • Kidney stone fragments were left behind, so they had to undergo ESWL again

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