Recomended Treatment Option for Kidney Stones less than 2 cms by the
American Urological Association and Europen Association of Urology
WHAT IS ESWL?
Extracorporeal Shock Wave Lithotripsy (ESWL) is a non invasive treatment option available for kidney stones less than 2 cms. Electromagnetic waves from outside the body are targeted on to the stone. These waves break the stones into small fragments of 2-4mm, which are expected to pass out in the urine within couple of weeks.
WHAT DOES THE TREATMENT INVOLVE?
The patient will be positioned on a ESWL table. A soft water filled cushion will be placed on to the patients abdomen or back. Using Ultrasound machine, the body is positioned so that the stone can be targeted precisely with the shock wave. Each sitting will last for about 45-60 minutes. The complete treatment may take 1-2 sittings, depending upon the hardness of the stone with a gap of 3-10 days between each sitting.
DOES ESWL TREATMENT IS PAINFUL? OR IT REQUIRES ANY ANAESTHESIA?
ESWL procedure is not painful and it does not require anaesthesia in adults. Few patients may experience some kind of discomfort or mild pain during the procedure. However, in children the procedure is done under General Anaesthesia.
CAN ALL STONES BE TREATED WITH ESWL?
Soft to moderately hard stones less than 2 cms located in the Kidneys, Upper Ureter and Terminal Ureter (VUJ) can be treated with ESWL. ESWL is not effective for Mid Ureteric. Kidney Stones more than 2 cms are not Ideal for ESWL.
WHAT ARE THE SUCCESS RATES OF ESWL?
Overall success rates of ESWL are in the range of 80-90%. About 10% the stone may not break at all or it breaks but will not get expelled from the Kidney or Ureter. In either case an endoscopic procedure like RIRS or PCNL or Ureteroscopy with DJ Stenting is required.
WHAT CAN A PATIENT EXPECT AFTER TREATMENT?
Some patients may notice blood stained urine, which usually resolves within a day. Most of the patients experience abdominal pain when the fragments are moving down, which generally responds to simple analgesics prescribed.
HOW LONG DOES THE FRAGMENTS TAKE TO CLEAR FORM THE BODY?
In most of the patients, the fragments will clear within a span of 1-4 weeks. If fragments persists beyond 4 weeks, then the patient has to be on regular follow up till the fragments clears or should undergo an endoscopic surgery to clear them.
DOES THE PATIENT NEEDS TO BE HOSPITALISED?
ESWL is a Day Care Procedure. The patients will be discharged on the same day and most people can fully resume their routine daily activities within a day.
ARE THERE ANY MAJOR SIDE EFFECTS OF ESWL?
No, ESWL is the most safest and least invasive treatment available for the kidney and ureteric stones. Standard guidelines recommends ESWL as the first line of treatment for kidney stones less than 2cms.
WHAT IS THE COST OF ESWL & IS THIS PROCEDURE COVERED UNDER INSURENCE?
The cost of ESWL depends upon the size of stone. Stones upto 10 mm will cost about 40k, 10-15mm will cost 50 k and 15-20 mm will cost 60K. The mentioned cost includes two sittings of ESWL. This treatment is covered under insurance. However, it is not a cash less but the procedure cost is reimbursable.
WHY THE STONES SHOULD BE TREATED WHEN THEY ARE IN THE KIDNEY?
ESWL has a good success rates when the procedure is done for kidney stones. Once the stone pass down the Ureter, ESWL success rates drops. Patients experiences severe symptoms and in most cases requires hospitalisation and an expensive endoscopic surgery.