Thursday, January 20, 2005
More about shockwave lithotripsy than you wanted to know
Extracorporeal shockwave lithotripsy (ESWL) is the most frequently used procedure for the treatment of kidney stones. In ESWL, shock waves that are created outside the body travel through the skin and body tissues until they hit the denser stones. The stones break down into sand-like particles and are easily (I hope!) passed through the urinary tract in the urine.
There are several types of ESWL devices. In one device, the patient reclines in a water bath while the shock waves are transmitted. Other devices have a soft cushion on which the patient lies. Most devices use either x rays or ultrasound to help the surgeon pinpoint the stone during treatment. For most types of ESWL procedures, anesthesia is needed. (No! Demanded)
In some cases, ESWL may be done on an outpatient basis. Recovery time is short, and most people can resume normal activities in a few days.
Complications may occur with ESWL. Most patients have blood in their urine for a few days after treatment. Bruising and minor discomfort in the back or abdomen from the shock waves are also common. To reduce the risk of complications, doctors usually tell patients to avoid taking aspirin and other drugs that affect blood clotting for several weeks before treatment.
Another complication may occur if the shattered stone particles cause discomfort(!) as they pass through the urinary tract. In some cases, the doctor will insert a small tube called a stent through the bladder into the ureter to help the fragments pass. Sometimes the stone is not completely shattered with one treatment, and additional treatments may be needed. ESWL is not ideal when stones are larger than 2 centimeters (mine is allegedly 8cm, uh oh!), about 0.8 inches. Is this what Alberto Gonzales calls waterboarding?