Urology |
D11
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Extracorporeal Shockwave Lithotripsy
Extracorporeal Shockwave Lithotripsy (ESWL)
What does the procedure involve?
This involves the administration of shockwaves through the skin to fragment urinary tract stones into fragments that are small enough to pass naturally. The procedure involves either x-ray or ultrasound scanning to localise the stone(s).
What should I expect on my visit for this procedure?
ESWL is carried out as a daycase procedure in the Urology Outpatient Department.
On arrival, an X-ray may be taken to confirm the presence of your stone(s). You will then need to sign a consent form saying that you agree to treatment.
Normally, no anaesthetic is necessary and you will be awake throughout the procedure. Pain relief and anti-inflammatory medication are given in the department prior to treatment.
The treatment will be monitored by a nurse and a lithotripsy technician. The shock waves can cause deep discomfort in the kidney and a sensation of being flicked with an elastic band on the skin of your back. If this proves excessively painful, additional painkiller and sedation can be administered during the treatment. Treatment normally lasts between 30 and 60 minutes, depending on the size of your stone(s).
What happens immediately after the procedure?
After the treatment you will be asked to remain in the out-patients waiting area until we are happy that you have recovered sufficiently to go home. The Specialist Nurse will also perform routine post procedure checks including pain scoring and urine colour monitoring.
As soon as you have recovered from the treatment, you will be able to go home but you should bring someone with you to escort you home; you should not attempt to drive yourself because of the effects of the sedation.
What should I expect when I get home?
When you get home, you should drink plenty of fluid to flush your system through and minimise any bleeding or infection. Painkillers should be taken as necessary and you should ensure you have painkillers at home.
Some blood in the urine is normal for 48-72 hours. If you develop bruising/blistering in your loin or on your abdomen, simple skin creams will usually ease any discomfort and the bruising normally resolves within 7 days.
What else should I look out for?
If you develop a fever, severe pain on passing urine, inability to pass urine or worsening bleeding, you should contact your GP immediately. Small blood clots or stone fragments may pass down the ureter from the kidney, resulting in renal colic; in this event, you should contact your GP immediately.
Follow up
A letter will be sent to you with an appointment date for the stone clinic. In this clinic you will have another X-ray to monitor the success of the treatment and a decision will be made about any further treatment.