ESWL: Symptoms, Classification, Diagnosis & Recovery

Extracorporeal shock wave lithotripsy (ESWL) is a procedure that involves breaking up stones in the urinary tract, bile ducts, or pancreatic ducts by using shock waves generated by a lithotripter.

The shock waves enter the body and are accurately targeted using X-ray imaging. The procedure aims to break the stones into smaller pieces that can either pass naturally through the body or be more easily collected.

For stones in the kidneys and ureter, the fragments will be expelled with urine. For Larger stones in the bile ducts or pancreatic duct, they are removed using an endoscope—a flexible tube inserted through the mouth.

Classification

The following are the main classifications:

Based on the Shock Wave Generator Type

• Electrohydraulic Lithotripters: They use underwater sparks to generate shock waves.
• Electromagnetic Lithotripters: They use electromagnetic coils to produce shock waves.
• Piezoelectric Lithotripters: They employ piezoelectric crystals that expand and contract to produce shock waves.

Based on the Targeting Method

• Fluoroscopy-Guided ESWL: Uses X-ray imaging to locate and target the stone.
• Ultrasound-Guided ESWL: It uses ultrasound imaging to locate and target the stone.

Based on Stone's Characteristics

• Size of Stone
• Composition of Stone
• Calcium-based stones

Based on the Location of Stone

• Kidney stones: Typically easier to treat with ESWL.
• Ureteral stones: May require different positioning or additional treatments.

Patients show various signs and symptoms before undergoing Extracorporeal Shock Wave Lithotripsy (ESWL). Here are the common signs and symptoms that may be observed:

• Flank Pain
• Abdominal Pain
• Hematuria (Blood in Urine)
• Urinary Urgency and Frequency
• Painful Urination (Dysuria)
• Nausea and Vomiting
• Fever and Chills
• Cloudy or Foul-Smelling Urine