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Extracorporeal Shock Wave Lithotripsy (ESWL)
Archeological findings gave profound evidence that men suffered from kidney and bladder stones for centuries. Urolithiasis is the condition where urinary calculi or stones are formed or located anywhere in the urinary system. It is the process of stone formation within the kidney, bladder, and/or ureters. Formation begins from minute crystallized salts that bind together that later solidify. If the crystallized materials remain small enough, it will travel through the urinary tract and may spontaneously pass out unnoticed. (1)
When the urinary stone is large enough to cause an obstruction on the flow of urine, patients may experience unimaginable pain.
Urolithiasis is prevalent worldwide and it is considered third commonest urological problem (2). It is common in middle age persons, agewise peak incidence is in second to fourth decade (3), with a mean age of 29 years (4).
What are the symptoms?
Common symptoms of urinary stone disease includes:
- Pain in the lower back, flanks or inguinal area
- Blood in the urine
- Fever/ Infections
- Nausea and vomiting
- Painful urination
How is it diagnosed?
Should you experience any of the symptoms listed above, visit your friendly urologist at The Urology Center of the Philippines for immediate consultation. Our experts will perform thorough physical examination. Laboratory and imaging modalities will also be performed to further assess the urinary stone.
The goal of any kidney stone surgical treatment is to achieve maximal stone clearance with minimal morbidity to the patient (5).
Extracorporeal shock wave lithotripsy (ESWL) is a non-invasive treatment of urolithiasis. It uses acoustic pulse to break a kidney stone into small pieces that can easily travel through the urinary tract and passes from the body.
Advances in ESWL have significantly decreased the indications for open stone surgery, which is now often a second- or third-line treatment option needed in 1.0-5.4% of cases only (6).
It is an effective procedure for treatment of patients with renal and ureteric stones (7). It is done as an outpatient procedure. You go home after the treatment and do not have to spend a night in the hospital.
Currently, The Urology Center of the Philippines, Inc. utilizes three ESWL machines. The Urology Center of the Philippines Hospital at Maginoo Street Diliman Quezon City has two (2) ESWL machine – a Dornier Compact Delta II and Dornier Compact Sigma. The Compact Delta II utilizes proven Dornier Electromagnetic Shock wave Emitter (EMSE) technology to deliver consistent, reliable energy. The Stone Unit-Manila Doctors Hospital has also the Dornier Compact Delta II.
1. Lopez M, et.al. History, Epidemiology and Regional Diversities of Urolithiasis. Pediatr Nephrol (2010) 25:49–59
2. Tanogho EA, McAninch JW, (edi). Urinary stone disease. Smith's general urology. 15th ed. San Francisco: McGrawHill, 2000: 291-320.
3. Menon M, et.al. Urinary lithiasis. In: Walsh PC, Retik AB, Vanghan ED, Wein AJ, (edit). Campbell' urology. 7th ed. Philadelphia: WB Saunders, 1998. 2659-734.
4. Arain GM, Malik SA. Urinary calculas disease: a study of 267 cases at Sir Ganga Ram Hospital Lahore over 2 years. Biomedica 1997; 13: 38-41.
5. Paterson R, et.al. Shock Wave Lithotripsy Monotherapy For renal Calculi Int Braz J Urol Vol. 28 (4): 291-301, July - August, 2002
6. Assimos DG, Boyce WH, Harrison LH, et al. The role of open stone surgery since extracorporeal shock wave lithotripsy. J Urol 1989 Aug;142(2 Pt 1):263-7.
7. Butt A., et.al. Extracorporeal Shock Wave Lithotripsy JCPSP 2005, Vol. 15 (10): 638-641