Lithotripsy

Lithotripsy or ESWL (Extra corporeal Lithotripsy) is a technique of breaking stones inside the body without entering the body through telescopes.

It involves focusing of modified sound waves which we generate inside a machine called lithotripter.

Focusing is done using an ultrasound machine or X-ray machine.

These modified sound waves pass through skin and the internal tissues to reach the stones where it has the maximum impact.

They break the stones over the weak links in the stones, thus allowing it to disintegrate into sizes which can easily pass through the natural urinary tract.

Typically, stones of sizes less then 10mm are favourable for such treatment. Sizes more than that need use of stents before administering the lithotripsy treatment.

Treatment

ESWL is given in sessions each lasting for 45 minutes.

There is no need to be admitted in the hospital or remain fasting. The person walks out after each session and can be back to work the same day. 2 -3 sitting (sessions) enable the doctor to make sure that the stones are broken into the smallest size possible so as to not give pain while passing out of the body.

There is no anesthesia involved as it is totally painless. Ocassionally painkillers are given as tablets after the session, to help relieve pain when stone fragments pass out of the urine.

After the session is over, repeat imaging with X-ray or ultrasound is done to assess the completion of the treatment.

Residual stones

ESWL is also used for stones called Residual stones.

These are the stones which are located in difficult locations not reachable by telescopes during surgeries like URS OR PCNL, but are smaller than 15mm in size.

Success of ESWL lies in the person following advice of taking large intakes of fluids in order to flush the fragments through the urine.

Secondly, maneuvers e.g. Exercise like skipping help in dislodging the fragments into more favourable portions.

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