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Endourology is the specialised branch of urology that deals with the closed manipulation of the urinary tract. It comprises all urologic minimally invasive surgical procedures, and is generally performed with the help of small cameras and instruments inserted into the urinary tract. This facilitates prostate surgery, surgery of tumours of the urothelium, kidney stone surgery, and various urethral and ureteral procedures.

Extracorporeal Shock Wave Lithotripsy (ESWL)

Extracorporeal Shock Wave Lithotripsy (ESWL) makes use of shock waves to disintegrate a kidney stone into small pieces so that they can travel easily via the urinary tract and pass out of the body.

The Procedure
  • In this procedure, the patient lies on a water-filled cushion, and the surgeon uses X-ray or ultrasound tests to accurately identify and locate the stone. High-energy sound waves are passed through the body, thus fragmenting the stone into small pieces, which enables them to pass through the urinary tract and out of the body easily.
  • The entire process takes only about an hour and is performed using local anaesthesia.
  • A stent may be placed in the ureter if you have a large stone, to allow small stone pieces to easily pass without causing ureter blockage

ESWL is generally an outpatient procedure. Following the treatment, stone fragments tend to pass in the urine for a few days, which could result in mild pain.

Why it is Done

ESWL is usually performed on those suffering from kidney stones that are causing pain or blockage of urine. Kidney stones that are between 4 mm and 2 cm in diameter are usually treated with ESWL. It also treats stones in the kidney or in the part of the ureter that is adjacent to the kidney.

However, ESWL is not recommended if the individual is:

  • Pregnant
  • Has a bleeding disorder
  • Has infection in the kidney or urinary tract
  • Has kidney cancer
  • Has abnormally structured kidneys or if there is problem in the functioning of the kidneys
Risks or Complications
  • Intense pain caused by the passage of fragments of stone
  • Blockage in urine flow
  • Infection in the urinary tract
  • Bleeding on the outside of the kidney