Extra-corporal Shock Wave Lithotripsy
Extra-corporal shock wave lithotripsy is a non-invasive treatment for kidney stones. It is sometimes also referred to as kidney stone shockwave treatment. This treatment has been used reliably since the 1980s to treat urological stones.
Extra-corporal shockwave lithotripsy involves the use of a specialised piece of medical equipment – known as a lithotripter – to generate high frequency shock waves. The urological surgeon uses the guidance of an ultrasound probe to visualize the stone and then direct the shockwaves via the lithotripter into the body, at the kidney stones. The shock waves vibrate and break the kidney stones up into smaller fragments, which can then be passed when the patient urinates.
What are kidney stones?
Kidney stones are also sometimes referred to as renal calculi or urological stones. Kidney stones are hard mineral deposits that form inside the urinary tract when calcium and other minerals from the urine clump together.
Stones can commonly form inside the kidney, and whilst here they often go undetected. However, they can often travel into the ureter, where they can cause painful urinary symptoms, which usually leads to their discovery.
There are many instances where small kidney stones pass on their own. If the stones are larger however, they can become stuck in parts of the urinary tract. This can cause a blockage that leads to pain, and in some cases even urinary tract infection. Other common kidney stone symptoms can include visible blood in the urine, flank/abdominal pain, nausea and fever.
Extra-corporal shock wave lithotripsy treatment for kidney stone disease.
Any kidney stones that are causing pain or other troublesome symptoms for the patient need to be treated. If you are an appropriate candidate, your urologist might recommend extra-corporal shock wave lithotripsy for the treatment of your kidney stones. In cases where ESWL is not an appropriate treatment for whatever reason, there are a number of other effective medical and surgical treatments that are available.
Melbourne Urology Centre has a team of fully qualified and experienced urologists that regularly perform extra-corporal shockwave lithotripsy at a number of locations throughout metropolitan Melbourne and regional Victoria.
Extra-corporal shockwave lithotripsy is most appropriate for patients with stones that are less than 1.5cm in diameter. For larger stones, extra-corporal shock wave lithotripsy may not be as effective, and an alternative method of treatment may be recommended by the urologist.
Extra-corporal shock wave lithotripsy is most effective when the stones are located either within the kidney itself, or within the ureter closest to the kidney.
During your consultations with your urologist, they will be able to advise you of your suitability for extra-corporal shock wave lithotripsy. They will take into account a number of factors, including:
- Size and shape of the stone that needs to be treated
- Location of the stone within the urinary tract
- Your general overall health
- The health of your kidney(s).
Are there any advantages to having extra-corporal shock wave lithotripsy for kidney stone treatment?
The major advantage of extra-corporal shockwave lithotripsy is that it is a non-invasive procedure; that is, it does not require for any incisions to be made. Even so, the procedure is most usually performed under sedation or general anaesthetic. This ensures that the patient remains still during the procedure and does not experience any discomfort. Most patients will not require a hospital stay, and are able to resume their normal daily activities within 1-2 days of having their treatment.
What should patients expect during and after having extra-corporal shock wave lithotripsy?
Extra-corporal shock wave lithotripsy is performed either under general anaesthetic or sedation. Even though there are no incisions involved, there may be some discomfort associated with the procedure, so an anaesthetic helps to keep the patient both comfortable and still throughout the duration of procedure.
During the extra-corporal shock wave lithotripsy treatment, the patient is positioned on the operating table in a position that allows the surgeon to access to the kidney stone location. Using an ultrasound, x-ray, or both, the stone is located precisely. The lithotripter probe is then used to accurately direct the shock waves to the location of the stone, breaking the stone up.
Extra-corporal shockwave lithotripsy will usually require anywhere between 1000-2000 shockwaves to effectively treat a kidney stone. The treatment usually takes 45-60 minutes to complete.
After having an extra-corporal shock wave lithotripsy, patients can expect to pass small fragments of stone in their urine for the next few days. Sometimes these are visible in the urine, but mostly it is ‘stone dust’ that passes undetected. Sometimes, larger stone fragments can cause some discomfort as they pass through. Some patients will report experiencing some mild abdominal discomfort, which may be associated with passing the stone fragments, depending on where in the urinary tract the stones were located. This discomfort is usually described as a dull ache and is generally subsides over the coming few days following the procedure.
After having an extra-corporal shockwave lithotripsy, you should aim to drink plenty of water. Your urologist can advise you on what amount might be right for you, but the general rule of thumb is to aim for clear urine. This helps you to maintain hydration, flush stone fragments from the urinary tract, and it will also assist in the prevention of future stone formation.
In some cases, repeated treatments of extra-corporal shock wave lithotripsy might be needed in order to break up stone fragments further. This will depend on the size, location and number of stones present to begin with. Your urological surgeon will advise you on the expected outcomes of your procedure and whether they believe that you will require additional treatments.
Extra-corporal shockwave lithotripsy at Melbourne Urology Centre.
Dr Shekib Shahbaz and Dr Tony de Sousa of Melbourne Urology Centre perform extra-corporal shockwave lithotripsy at a number of locations throughout Victoria.
If you are interested in having a consultation with our urologists to see if extra-corporal shockwave lithotripsy is an appropriate treatment for you, please telephone our rooms or complete the online contact form. Please note that you will need a referral from your GP addressed to our urologists in order to be able to secure an appointment time.