ESWL treatment with Sonolith®
What is ESWL treatment for urinary tract stones?
Extracorporeal Shockwave Lithotripsy (ESWL) is the least invasive technique commonly used for treatment of urolithiasis when possible (depending on stone location, stone dimension and patient medical condition).
This non-surgical procedure using shock waves, developed in the mid-1980's, fragments stones into small pieces which pass spontaneously several days or weeks later from the kidney and bladder in most patients.
Extracorporeal Lithotripsy is a non-invasive procedure that uses sophisticated technology combining X-ray, ultrasound, and acoustic shock waves to diagnose and disintegrate urinary stones.
The patient is comfortably positioned on a table and after localization through X-ray or ultrasound the stone is targeted by a series of shock waves generated outside of the body. Shock waves travel through water and are focused on the stone for an accurate disintegration.
Who can be treated with ESWL?
During a medical examination, the urologist decides which mode of treatment is recommended to the patient. The evaluation may include routine blood and urine tests, X-ray, ultrasound and electrocardiograms. Careful patient selection for this type of procedure is important.
If ESWL treatment is chosen by the physician, then size, location and consistency of the stone determine the number of shock waves needed for an accurate fragmentation (between 1000 and 3500 shocks) and in general, treatment duration lasts between 30 to 50 minutes.
Before treatment the stone is precisely localized in the urinary tract through X-ray or ultrasound.
When the patient is correctly positioned on the table and your stone accurately located, the treatment can begin with monitoring of the fragmentation process during the procedure.
Is ESWL treatment painful?
ESWL treatment with Sonolith® is almost pain-free and no anesthesia is required. The patient is given a light analgesia to make treatment confortable and to avoid patient movements during treatment.
What happens after treatment ?
Only a few hours after treatment, the patient can go back home accompanied by a relative and can go back to normal activity just 24 hours after treatment.
The stone debris will naturally pass through the urine the following days. The evacuation of theses debris may result in discomfort when they actually pass through the urethra.
The physician may ask you to filter the urine in order to collect the debris and have them analyzed by a laboratory. This analyse will determine the stone composition and may be used to implement a preventive treatment to avoid recurrence.
What are the side effects of EWSL?
ESWL treatment is very safe and has little and mild side effects that go in only a few days.
Blood in the urine (hematuria): this is very frequent after ESWL treatment as a result of trauma to the renal parenchyma. However the amount of blood in the urine is minor and the symptom stops spontaneously within 24-48 hours after treatment.
Pain (nephretic colic/pain) : this pain is caused by the evacuation of stone debris through the urethra. The pain naturally wears off in a few days at the most. Painkillers may be prescribed to stop pain.
Petechia (small red or purple spot on the body, caused by a minor bleeding of capillary vessels on the skin) is caused by the shock-waves and it wears of in a few days.
Urinary tract infections may appear in rare cases (in 1 to 7% of patients): it is caused by bacteria being released when infected stones are broken. The risk of infectious complications following extracorporeal lithotripsy can be minimised by administering prophylactic antibiotics to patients suffering from urinary tract infections to avoid further complications such as pyelonephritis.
Urinary obstruction (in up to 6% of patients) : such obstructions are caused by stone fragments lodging in the ureter. The patient usually feels persistent pain and a procedure may be necessary to clear the ureter if the fragments are not eliminated spontaneously.
What is the medical follow-up after ESWL treatment?
After the ESWL treatment with Sonolith®, the patient goes home the same day with a prescription for anti-inflammatory medecine to be taken for a few days.
Then, about 3 weeks after treatment, the patient is asked to have a control X-ray to check that the stone has satisfactorily been evacuated.