Let's learn about the non-surgical method of breaking down kidney stones (ESWL)?

Do you also have kidney stones and can't stand the pain? Sometimes, the pain of these stones getting stuck is unbearable, right? So, have you heard of a treatment that uses shock waves outside the body to break up these stones without surgery? Today, let's talk about this treatment called ESWL, or Extracorporeal Shock Wave Lithotripsy.

Simply put, what is ESWL?

ESWL is a very common, non-surgical treatment. It uses high-energy shock waves from outside the body to break up stones in your kidneys or ureters into small pieces. It's like hitting a small rock with a hammer. The broken pieces of stone are then easily passed out of your body in your urine, like grains of sand.

Kidney stones form when the concentration of certain substances, such as calcium, in our urine increases. Although they first form in the kidneys, sometimes they break free and travel down the ureters, the tubes that carry urine to the bladder. Small stones often pass out with the urine. But some stones are a little bigger. They can't come out that easily, they get stuck in the tubes. That's when unbearable pain occurs. ESWL treatment works by breaking up the stuck stones and making a way for them to come out.

In what cases is ESWL treatment necessary?

Doctors usually recommend ESWL treatment in the following cases:

• If the stones are large: Stones that are usually larger than 5 millimeters (about the size of a pencil eraser) are difficult to pass with urine.
• If the flow of urine is obstructed: If the stone becomes lodged and urine flow stops, the kidney can be damaged.
• If there is severe pain: If the pain is difficult to control.

Before recommending treatment for you, your doctor will consider several other factors.

How do you prepare before treatment?

Your doctor will explain to you what you need to do before this treatment. These may include:

• Blood and urine tests: You may be asked to do several tests to check kidney function, blood counts, and urinary tract infections (UTIs).
• Medication Information: Tell your doctor about all medications you are taking . If you are taking blood- thinning medications, you may be asked to stop taking them a few days before your treatment. Never stop taking any medications without your doctor's advice.
• Fasting: You will be asked to stop eating and drinking for a few hours before the treatment.
• Someone to drive you home: Since you will not be able to drive after treatment, bring someone to drive you home.

How is this treatment performed?

Before the treatment begins, you will be given a numbing medicine (`(Anesthesia)`) to prevent you from feeling any pain. You may be put completely to sleep, or you may be made to feel like you are intoxicated. Sometimes, only the area below the waist may be numbed.

This is what happens during treatment:

1. You will be made to lie down on a special bed with a cushion filled with water.

2. Then, using an X-ray or ultrasound scan, they find the exact location of the stone.

3. The machine and your body are adjusted so that the shock waves hit the stone precisely.

4. Next, the ESWL machine sends high-energy shock waves through the body to the stone. If you are conscious, you may hear a "tick-tock" sound from the side.

5. In this way, thousands of shock waves are directed and the stone is crushed into small pieces.

The entire process usually takes about an hour , but this time may vary depending on the size and number of your stones, and your health condition.

What happens after treatment?

ESWL is usually an outpatient treatment, but you will need to stay in the recovery room for a few hours after the treatment.

Symptoms such as these may occur for a few days after treatment:

• Body pain: You may feel some bruising and pain on the treated area.
• Blood in the urine: It is normal for urine to turn pink.
• Pain when urinating: It is normal to experience a little pain when the crushed stone fragments pass out.

These symptoms usually go away within a few days.

How long does it take for the stones to come out?

For a few days or weeks after treatment, you may pass stone fragments in your urine. These may look like grains of sand or small pieces of stone. You may feel pain when these fragments pass. Your doctor may prescribe medications such as:

• `Tamsulosin`: This relaxes the bladder and urethra, helping the stones pass more easily.
• `Ketorolac`: This is a painkiller.

It is also very important to drink plenty of water to help flush out the stones.

When to seek immediate medical advice

If any of the following symptoms occur, immediately go to the nearest hospital Emergency Department (ETU) or inform your doctor.

Who is not suitable for this treatment?

ESWL treatment is not suitable for some people. For example:

• Pregnant women
• People with bleeding disorders
• People who cannot stop taking blood- thinning medications
• People with uncontrolled high blood pressure
• People with kidney infections or cancer
• People with obesity

Your doctor is the best person to decide whether this treatment is right for you, so please share all of your health information with him or her.

Kidney stones, ESWL, lithotripsy, kidney stone treatment, non-surgical, shock waves, urinary stones, kidney stones Sinhala