ESWL Treatment

ESWL Treatment is a method that enables the breaking of stones in the urinary tract and kidneys by targeting them with shock waves sent from outside the body. The aim is to break the stones into small pieces and enable them to be secreted through the urinary tract spontaneously.

Patients who are strictly recommended not to be treated with ESWL

1-Pregnant women

2-Bleeding – those with coagulation disorders

(patients using anticoagulants should discontinue their medication 1 week before the procedure in consultation with their doctor)

3-those with extreme skeletal malformations

4-patients with aortic and renal artery aneurysm

5-overweight people

 

What are the success rates of the ESWL Treatment procedure?

The complete elimination rate of the ESWL method is 84% for stones smaller than 1 cm, 77% for stones between 10-20 mm and 63% for stones larger than 2 cm in diameter.

The composition of the stones can play an important role in how it breaks down and is eliminated from the body. Uric acid and calcium oxalate dihydrate stones break more easily than calcium oxalate monohydrate stones. Cystine stones are the hardest and most resistant to ESWL.

Stones can be listed as struvite (infection stone), calcium apatite, uric acid, calcium oxalate dihydrate, calcium oxalate monohydrate and cystine stones according to how easily they disintegrate.

 

How many times can ESWL Treatment be applied?

The number of ESWL sessions should be limited to a maximum of 5-6 sessions to avoid damage to the kidney tissue and prevent bleeding. Percutaneous stone surgery would be more appropriate for patients, since the number of sessions required for larger stones exceeds this number.

 

How long should the interval between ESWL Treatments be?

Since the risk of damage is evident in treatments targeting kidney stones, it should be done with 4-5 days intervals. In the treatment of urinary tract stones, the interval between treatment periods can be shorter.

 

Can ESWL Treatment Be Applied to Pediatric Patients?

The most important treatment option in the treatment of kidney and urinary system stones in children is ESWL (lithotripsy with shock waves). ESWL should be performed under general anesthesia in pediatric patients, repetitive sessions should be avoided, and close follow-up should be carried out after treatment.

 

Is the presence of a kidney cyst an obstacle to the application of the ESWL method?

Kidney cysts are not an obstacle for ESWL.

 

What should be done to prevent the recurrence of stones?

An analysis of the kidney stones should be done to prevent the recurrence of such stones. Subsequently, the amounts of minerals that can cause stone formation should be investigated after a 24-hour urine and blood analysis, and treatments that provide normal values should be prescribed.

 

What should be done after the ESWL procedure?

Mobility should be increased after the procedure, sports and walks will help to shed the broken particles. In addition, daily fluid intake should be at least 1.5-2 liters.

 

Important points

– ESWL is the first treatment option in the treatment of kidney stones.

– ESWL limits should be well known and patient selection should be done well to get the best results from the procedure.

– The patient must be free of urinary infection before ESWL treatment.

– ESWL is a very effective method that can also be applied to children.

– Additional endoscopic treatments can be performed to increase the effectiveness of ESWL.

– Since the targeted area for stones in the kidney is the kidney, the number of sessions should be limited to 5-6 at most, and the session intervals should be 4-5 days. Increasing the number of sessions will greatly increase the risk of kidney damage.

– Treatment sessions can be increased for stones in the urinary tract, and shorter intervals between sessions are acceptable.

–If ESWL is planned for stones with a diameter of 20mm or larger, a ureteral J stent should be inserted before the procedure.

– If the stone size is over 1 cm in lower calyx stones, the success of percutaneous nephrolithotomy (closed kidney stone surgery) is higher than ESWL.