Kidney stone 101- Shock Wave Lithotripsy
Peachtree City and Atlanta’s Best Stone Surgery Doctors
Kidney Stone Treatments 101: Extracorporeal Shock Wave Lithotripsy (ESWL)
November 8, 2022
Going for your first ESWL treatment can be unnerving. What should you do to prepare for it? Is it going to hurt? Don’t worry – we got you! Here’s everything you need to know about ESWL for kidney stones.
What is ESWL?
Extracorporeal shock wave lithotripsy is a non-invasive procedure that uses shock waves to break up kidney stones in your urinary tract. The shock waves are transmitted by a machine (known as a lithotripter) and directed at the kidney stone, shattering it into smaller fragments. These fragments are left to pass out of your body when you pee.
Fun fact: Almost 95% of stones can be treated with ESWL. It is the most common treatment for kidney stones in the U.S.!
Who is it suited for?
Generally, ESWL works better for people with smaller stones that are less than 20mm in diameter⁴. However, it also depends on other factors, such as the size, shape and location of your stone. If your stone is too big (e.g. >20mm), we may recommend other treatment options, such as ureteroscopy (URS) or percutaneous nephrolithotomy (PCNL).
How should I prepare for my ESWL appointment?
Let us know if you’re taking any anticoagulants (blood-thinning medication) such as Warfarin, Plavix, Eliquis, or Xarelto. You may be advised to stop taking it 4 days before your procedure. ESWL is done with general anesthesia. You can not eat or drink for 8 hours before the procedure. Otherwise, you’re generally free to carry on with your daily routine.
Remember to arrange for a friend or family member to accompany you home!
What happens during the procedure?
The procedure usually takes about 45 minutes to an hour. In the treatment room, you will be asked to lie on a table. You will then receive anesthesia and you will not have any pain or discomfort.
After locating the stone with the help of an X-ray or ultrasound (or both), your body will be positioned so we can target the stone more precisely.
Using a lithotripter, a series of shock waves (usually 2,500) will be administered at the stone. During this process, your urologist will adjust the power and the intervals of the shock waves as needed to break the stone up.
Sometimes, if the fragments are still too large, another surgery might be required to extract them.
How should I take care of myself after treatment?
Good news – you will go home on the same day! Make sure to get lots of rest, and avoid any strenuous activity for the first few days.
At home, you can expect to start passing small sand like fragments through your urine. This may cause some blood in your urine and some mild pain for several days. This is normal and can often be treated with oral pain medication such as Tylenol. We also prescribe a medicine called tamsulosin to help widen the ureter to make it easier to pass sand like fragments.
Drinking lots of water will help to clear out the bloody urine and flush out stone fragments. You should also avoid alcohol for at least the first 24 hours, including beer. This is because the surface of your urinary tract is still raw after treatment, and alcohol may cause irritation.
During your recovery period, infection is uncommon. Infection would be manifest as fevers, chills, burning with urination and flu like symptoms. If you experience any of these symptoms, call us immediately!
*Please note- this is informational only and does not constitute medical advice.
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Ureteroscopy and laser lithotripsy
Stockbridge Atlanta’s Best Stone Surgeons
Kidney Stone Treatments 101: Ureteroscopy and laser lithotripsy (URS)
November 8, 2022
Nearly every kidney stone patient has heard of stents and the kidney stone treatment they’re most associated with: ureteroscopy. Having a telescope in your bladder may sound bizarre, but if you have small- to medium-sized stones (<20mm), here’s why ureteroscopy (URS) may work for you, and how you can prepare for it.
What is ureteroscopy (URS)?
Ureteroscopy is a kidney stone removal procedure that involves the insertion of a small telescope, called a ureteroscope, through the urethra and bladder, and up the ureter to the point where the stone is located.
This means that unlike extracorporeal shock wave lithotripsy (ESWL), your stone can be seen under direct vision through the ureteroscope. Your urologist will then either break down the stone into smaller fragments with a laser, or remove it with a basket-like device.
Even better? URS does not involve any skin incisions, which is required during percutaneous nephrolithotomy (PCNL).
Fun fact: URS is a good option for people such as airline pilots, who may not be eligible for other stone treatments like ESWL and PCNL!
What can I do to prepare for my URS appointment?
This procedure is done in our outpatient surgery centers with general anesthesia during the procedure. Remember not to eat, drink or smoke at least 6–8 hours before the procedure, and to arrange for a family member or friend to accompany you home afterward.
What happens during the procedure?
Ureteroscopy is performed under general anesthesia (which means you will be asleep), and the procedure usually lasts from one hour.
A safety wire is inserted through the ureter. Using the wire as a “pathway”, a ureteroscope (a long, thin device with a tiny camera at the end) will be inserted through your urethra and bladder, into your ureter to locate the stone.
For smaller stones, we will retrieve the stone with a small basket-like instrument. Larger stones may need to be broken down with a laser. The fragments will then be passed from your body with your urine.
How should I take care of myself after treatment?
After your surgery, you should rest for 3–7 days before you can resume your daily activities. You can also expect to see some blood in your urine. Keep drinking water, and this should clear up soon!
As your ureter may swell after URS treatment, you may require a stent. A stent is a long, thin tube used that helps keep your ureter open to prevent obstruction and help you pee.
Stents can cause temporary lower urinary tract symptoms, such as frequent urination, burning and blood. But don’t worry – these symptoms should go away entirely once your stent is removed! We also prescribe medicine such as oxybutynin to reduce frequency, pyridium to reduce burning, and stool softeners to help prevent constipation.
