GreenLight Laser Treatment for BPH
Extracorporeal Shockwave Lithotrispy (ESWL)
- The introduction of ESWL in the early 1980’s revolutionized the management of patients with kidney stones. ESWL is the only truly non-invasive treatment for kidney stones.
- Successful ESWL require; shock wave generation, focusing, coupling and stone localization
Contraindications for ESWL
- Uncontrolled coagulopathy
- Patients on blood thinners
- Patients with cystine stones
ESWL involved the administration of a series of shock waves to the stone. The shock waves are generated by a machine, are then focused onto the stone. The shock waves travel through the body, reaching the stone where they break it into small fragments like sand particles. For several weeks after the treatment, these small fragments come out in the urine.
If your stone is larger or you have multiple stones, you may require repeat treatment.
Sometimes, if you have a stone impacted in the upper or mid ureter, we may do a procedure to unblock the ureter and place a double J stent prior to ESWL.
Before your procedure
- Procedure will be done as an outpatient; either in the hospital of your choice or at the Surgery Center
- You will need Pre-operative Testing (EKG, chest x-ray and blood work). Hospital will call you to arrange this
- Please do not take any blood thinning medications for 7 days prior to your scheduled surgery date. These medications include Aspirin, Coumadin, Plavix, Percentine. Lovenox, Vitamin E, Motrin, Ibuprofen, Advil. Please contact our office if you are unsure about which medications to stop prior to surgery. Do not stop any medication, without contacting the prescribing doctor to get their approval.
- Please take some mild laxative for few days prior to surgery date and night before take a Fleet’s enema.
- The night before surgery, eat a light supper. Nothing to eat or drink after midnight
- The anesthesiologist will see you on the day of surgery to discuss your anesthesia
- Please arrive 2 hours before surgery
- Bring your driver’s license and your insurance cards with you
- Wear loose-fitting clothes and comfortable shoes
- Leave all valuables and Jewelry at home
- Be sure you have made arrangements with a responsible person – family member for your ride home
- Procedure will be done under mild to general anesthesia
- There are no incisions
- X-rays are used to see the stone and monitor the breakage of stone
- We may insert a double J stent or remove the stent if it was inserted in the past
What to expect after the procedure
- You will be transferred to recovery room and once your vital signs are stable, you will be sent home with your family members.
- Please drink plenty of fluids, this will help pass stone fragments
- Most patients will experience some degree of discomfort for a day or two after ESWL. The pain is described as a dull ache over the kidney.
- It is normal to see some blood in the kidney for several weeks.
- You may notice some bruising in the flank.
- Please call our office to make an appointment to see us in 2-3 weeks. We will perform an x-ray to determine if stone broke up into small pieces and if these small pieces have passed out of the kidney. If the stone fragments are still present, we will repeat x-rays. You may need either repeat ESWL or other treatment modalities.
- If all fragments have passed, we will arrange for you to have your double J stent removed.
- Don’t forget, after 3 months you should be seen in our office for diagnostic evaluation to know why you form kidney stones.
When to call us?
Although ESWL is a safe non-invasive treatment, adverse events, although rare, can happen. You should contact us if:
- Persistent pain
- Persistent blood or clots in the urine