Extracorporeal shockwave lithotripsy (eswl)

Lithotripsy is the breaking of kidney stones by pressure waves.

These waves are focused on the kidney stone with the use of ultrasound and X-rays. The pressure waves travel through the body tissues without damaging them and reduce the kidney stone to fine gravel which may be passed naturally in urine over a period of time, usually with no pain.

Lithotripsy is usually delivered through 3 treatments depending on the size and density of the stone, each lasting approximately 45 mins over a period of weeks or until the kidney stone is broken down so it can be passed naturally. You may experience some discomfort during treatment, similar to an elastic band being flicked against the skin, but pain relief will be available in consultation with the nursing staff and your consultant.

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Kidney stones can develop in one or both kidneys and most often affect people aged 30 to 60 years of age. They are quite common, with around 4 in 20 men and up to 3 in 20 women developing them at some stage of their lives. The medical term for kidney stones is Nephrolithiasis and if they cause severe pain this is known as renal colic.

SYMPTOMS

Pain in stomach, back & side
Pain during urination
Blood in urine
Urine Infection
Inability to empty bladder
Sickness

Small kidney stones may go undetected and be passed painlessly in the urine but are fairly common for a stone to block part of the urinary system, such as the:

Ureter - the tube connecting the kidney to the bladder

Urethra - the tube urine passes through on its way out of the body

A blockage can cause severe pain in the abdomen or groin and sometimes causes a Urinary Tract Infection (UTI).

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THE TREATMENT

After reporting to the reception area, the nurse will escort you to the patient's area.

A simple checklist will be completed and you may be asked to sign a consent form.

Any further questions you may have will be answered. After changing into a hospital gown, you will be given some pre-medication, this will probably take the form of a pain-relieving suppository.

You may be sent for a simple abdominal Ultrasound, X-ray, or CT scan prior to treatment.

Ultrasound examination image of renal sy

Computed radiography (CR) of bilateral kidney stones, R=right side.jpg

CT scan (computed tomography) of abdomin

You will then be escorted into the treatment area where you will meet our shockwave specialist,

who will position you on the table (this may be on your front, back or side depending on the position of the stone). The gel will be applied to your skin and care will be taken to ensure that you are comfortable.

Most patients describe the treatment as being only slightly uncomfortable.

From this point, it is very important to keep quiet still and to breathe as gently as you can. Focusing on the stone may take a few minutes before treatment begins. Each pressure wave is accompanied by a 'clicking' sound and the sensation is often described as though you were being flicked on the skin with an elastic band. Treatment normally lasts about 30-40 minutes, being structured to your individual needs.

You will be taken to the recovery area. There you may rest and you will be asked to drink plenty of fluids. The nursing staff will inform you of a safe time for you to be discharged and give you details of your follow-up clinic appointment. Before leaving you may be given some painkillers/antibiotics in case you should feel any discomfort.

Advice following treatment

It is essential that you drink plenty of fluids. At least 2 liters/3.5 pints per day until your follow-up clinic appointment.

It is advisable that you rest for the day following treatment, after which if you feel well, you may return to normal activities and work.

After the first couple of days following your treatment, it is important for you to keep as active as you can as this will aid the passage of the fine stone fragments.