The Advantages of ESWL Technology Urology Center of Excellence

Extracorporeal shock wave lithotripsy (ESWL) is one of the urinary tract stone therapy procedures (BSK). ESWL uses shock waves to break up kidney stones which can then be passed through the urinary tract. It was first introduced in the early 1980s and is a non-invasive method for breaking up stones in the urinary system, using 'shock wave' energy. Common uses of ESWL are for kidney, ureter, and bladder stones. Here, Dr. Nouval Shahab, Ph.D., FICS, FACS Urology Specialist Doctor from Premier Jatinegara Hospital, who has been with the hospital since 2012 with the Urology Center of Excellence specialist team, shared his insights about the ESWL method.

The main advantage is that this procedure is completely non-invasive. This procedure can be performed in some cases within 60-90 minutes, and sometimes longer depending on the size and number of stones, but rarely requires hospitalization. In addition, this procedure does not require anesthesia, but only uses analgesic (painkilling) drugs. Because there are no incisions, patients can immediately carry out normal activities. This procedure is safe and can be used to treat patients of all ages.

Although the cost may vary, it is certainly more affordable compared to surgery.

Most patients experience some discomfort for a day or two, especially around the waist, but this can be managed by taking analgesics/painkillers. Second, urination can cause a visible reddish color in the urine for a few days to a few weeks. Finally, there may be small stone/sand fragments released when urinating, so that the urine is slightly gritty or cloudy. Light bleeding or hematoma around the kidney can be treated with rest, but this condition is rare.

Blood and urine laboratory tests are performed and include kidney function and blood clotting tests. Patients must stop (consuming) anticoagulant/blood thinning drugs a week before the procedure, and if ESWL is performed under anesthesia, patients need to fast for 6 hours before the procedure. Ultrasound imaging examinations, plain abdominal radiographs, and urography CT scans without contrast need to be carried out, and after the ESWL procedure, patients need to be alert if any sudden pain occurs in the stomach or waist that does not go away with analgesic drugs. In this case, the patient needs to return to the hospital for further treatment. This condition can arise because stone fragments fall together, disrupting the flow of urine.

The most difficult cases involve larger kidney stones and the patient does not want to undergo surgery. This is done with the ESWL procedure with placement of a double J Stent before the procedure. The Double-J stent is a ureteral stent with a curved tip that prevents the stent from slipping into the bladder or kidney. This procedure is carried out several times until all the stones are broken up and the kidneys are free of stones.

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