Extracorporeal Shock Wave Lithotripsy

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Extracorporeal Shock Wave Lithotripsy (ESWL)


Usually renal stone less than 15 mm are opted for these modality. Extracorporeal shock wave Lithotrispy (ESWL) uses highly focused sound waves projected from outside the body to crush kidney stones anywhere in the urinary system. ESWL by 4th generation Siemens Variostar with Ultrasound attachment helps to treat even Radiolucent stones, which are not visible in normal fluoroscopy Lithotriptor. It eliminates the use of harmful radiation to patients during ESWL. ESWL is done on the Out door patient procedure. ESWL requires no anaesthesia hence patient can walk home within few hours of ESWL. At our centre we offer newer application of shockwave in pain management and for tendinopathy.

ESWL May Be A Good Option For:
eswl treatment
  • Stones that can be seen on an x-ray (are radio-opaque)
  • Kidney stones less than 20 mm
  • Ureteral stones less than 10 mm
ESWL May Not Be A Good Option For:
  • Stones in the bottom part of the kidney (lower pole stones)
  • Mid ureteral stones - Treating stones in the region of the ureter overlying the bony pelvis is not recommended because bone blocks shockwaves and makes it difficult to find the stone.
  • Distal ureteral stones - These stones are often better treated by ureteroscopy
  • Chronic infection - The only way to stop chronic infection associated with kidney stones is to completely remove the stones. ESWL tends to leave small fragments behind.
  • Obstruction distal to stone - if the ureter is blocked by scarring or some other process, the stone fragments are unlikely to pass.
  • Patients on blood thinners - ESWL treatment carries a risk of bleeding from the kidney.
  • Obesity - Stones can be difficult to see in heavier patients. Most ESWL units cannot support a patient heavier than 350 pounds.
  • Patients who require complete stone clearance - It may take up to three months for all fragments to clear after ESWL and that time period may be unacceptable for some patients.
Success Rate Of ESWL:

As with any medical procedure, your doctor can't guarantee success. To give our patients the best chance at getting rid of stones, we select patients who are most likely to succeed before recommending ESWL.

Much of the research evaluating the effectiveness of ESWL was completed before CT scans were commonly used for stone disease. Therefore, it is difficult to compare older research with current research.

Stone Surgery & Lithotripsy:
stone surgery - eswl

Dr. Pattnaik is pioneer in endourology in India. He is among few of the urologist who started to work on endourology when other centres offered open surgery for patients with urinary stone disease. Dr. Pattanik has got many innovations and publications in endourology on international form. Our centre is known as referral centre for difficult cases where other centres fail to achieve complete stone clearance by endourology and also for patients who are high risk for such surgery.

Extracorporeal Shock Wave Lithotripsy (ESWL) :

Shock wave lithotripsy, or ESWL, is an outpatient procedure and is performed under general anesthesia. And completed in an hour. The stone is located by X-Rays and the doctor directs high-intensity sound waves on the located stone. This high-intensity sound waves break the stone into tiny fragments (about the size of grains of sand) so they may then flush out of the body with the urine. The major advantage of ESWL is that it doesn't require incisions. During ESWL, it is possible that some stones may not break or may break into large pieces that are difficult to pass. There is a limit to the number of shock waves that can be safely administered in a single treatment session. While many ESWL patients are free from stones three months after the procedure, some require additional treatments.

Percutaneous Nephrolithotomy (PCNL):

Percutaneous nephrolithotomy is performed

through a 1-cm skin incision and thus minimizes incision size, pain, blood loss, blood transfusions and shortens hospitalization. This technique also has a higher success rate for clearing all stones in one setting than other techniques.

Pinhole Surgery (Micro, Ultra-Mini And Mini PCNLs):

No Cutting, No Bleeding, and no need for Anaesthesia. Pinhole Surgeries improve success rates, shorten recovery, reduce complications and open up new methods of diagnosis and treatment. Many of these pinhole procedures have replaced traditional open surgeries procedures. We SS Hospital is the first to introduce Pinhole Surgery in Mumbai.

Flexible Scope Of All Sizes For Retrograde Intra Renal Surgeries (RIRS):

RIRS is used for patients with stones in the kidney, narrowing of the outlet of the kidney or within the kidney (strictures) and tumors in the kidney. The RIRS is an outpatient procedure using local, intravenous or general anesthesia.

Ureteroscopic Removal Of Stone (URS):

This is endoscopic treatment of ureter stones using a mini-scope. Under general anaesthesia, the scope is passed via the urethra into the bladder and up the ureter. Using a laser or lithoclast probe, direct contact is made on the stone to break it into smaller pieces. These tiny stone pieces will pass out on their own. Sometimes a wire basket is used to extract the stone pieces. This surgery takes 30 mins on average and can be done as a day case under general anaesthesia.