Extracorporeal shock wave lithotripsy (ESWL) for upper urinary tract stone
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Patients with renal colic usually present with loin pain, vomiting,and may have fever with hematuria. The diagnosis should be protected by an appropriate imaging procedure as: Ultrasound of the Urinary Tract plain x-ray for the kidney ureter and bladder, CT scan of the abdomen and pelvis . Extracorporeal shock wave lithotripsy (ESWL) is the most frequently used procedure for the treatment of upper tract stones. ESWL is the fragmentation of stone by means of acoustic shock waves created by an extracorporeal source that travels through the skin and body tissues until they hit the dense stone, they break it by spallation and squeezing the stones to break down into small particles which can easily pass through the urinary tract in the urine.
ESWL may be done on an out-patient basis. Recovering time is relatively short and most people can resume normal activities the second day.
The ESWL cannot be used in the following cases:
- Pregnancy
- Major UT congenital analysis
-Aortic aneurysm
-Uncontrolled coagulation disorders
-Untreated urinary infection
-Patients with Pacemaker
Complications may occur with ESWL:
-Blood in the urine for few days after treatment
-Bruising and minor discomfort in the back or abdomen.
Some instructions related to Treatment:
Patient with infection stones and recent history of urinary tract infection should be administrated by antibiotics before the stone removing procedure and continued for at least 4 days afterwards.
Patient should avoid taking Aspirin and other medicines that affect blood clotting for several days before treatment
Sometimes the stone is not completely shattered with one treatment and additional sessions may be needed.
Asymptomatic and non infected residual fragments less than 4 mm must be followed up
Conclusion:
It is safe procedure and can applied for children and people with solitary kidney.
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