รักษานิ่วในไต กับการสลายนิ่วด้วยคลื่นกระแทก (ESWL)

Stones are formed from the accumulation of waste deposits that settle and accumulate into small stones, which gradually grow larger. They are commonly found in the urinary system, such as kidney stones, ureteral stones, urethral stones, and bladder stones. Men are more likely to develop stones than women because the male urinary tract is longer and more convoluted than that of females, allowing stone deposits to accumulate more easily.
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<h2>What is Shock Wave Lithotripsy (ESWL)?</h2>
Shock Wave Lithotripsy (ESWL: Extracorporeal Shock Wave Lithotripsy) is a non-surgical treatment for stones that does not require general anesthesia. The doctor uses a lithotripter machine to send sound waves through the skin directly to the stone, causing shock waves that create cracks and break the stone into small pieces or powder, allowing the stones to pass out with the urine.
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<h2>Limitations of Shock Wave Lithotripsy (ESWL)</h2>
Shock Wave Lithotripsy has some limitations. It cannot be used for all types of stones, and some stones are difficult to break, such as cystine stones or calcium oxalate monohydrate stones. Even small stones may require repeated treatments or may fail to break successfully.
The doctor will determine the most appropriate treatment method or may combine several methods to achieve the best results and avoid unnecessary complications. Stones that can be treated with shock wave lithotripsy should have the following characteristics:
<ul>
<li style="font-weight: 400">The stone size should not be too large, for example, kidney stones should not exceed 2 cm, and ureteral stones should not exceed 1-1.5 cm.</li>
<li style="font-weight: 400">There should be no obstruction in the urinary tract below the stone.</li>
<li style="font-weight: 400">The kidney with the stone and requiring lithotripsy should still be functioning normally.</li>
</ul>
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<h2>Who cannot undergo Shock Wave Lithotripsy?</h2>
<ul>
<li style="font-weight: 400">Those with stones that are too large.</li>
<li style="font-weight: 400">Pregnant women.</li>
<li style="font-weight: 400">People who are overweight.</li>
<li style="font-weight: 400">People with unstable or uncontrolled blood pressure.</li>
<li style="font-weight: 400">People with inflammation or bacterial infection in the urinary tract.</li>
<li style="font-weight: 400">People with abnormal bleeding conditions, blood clotting disorders, or those taking anticoagulant medications.</li>
<li style="font-weight: 400">People with urinary tract obstruction below the stone.</li>
<li style="font-weight: 400">People with abdominal aortic aneurysm.</li>
</ul>
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<h2>Preparation before Shock Wave Lithotripsy</h2>
<ul>
<li style="font-weight: 400">When the doctor recommends shock wave lithotripsy, the patient should come for treatment as scheduled. However, if any abnormalities occur before the appointment, such as fever or severe pain, the patient should see the doctor earlier.</li>
<li style="font-weight: 400">Avoid eating and drinking for at least 6-8 hours before the procedure.</li>
<li style="font-weight: 400">Take regular medications as usual, such as blood pressure or diabetes medications, but stop blood-thinning drugs like aspirin or warfarin at least one week before the procedure or as directed by the doctor.</li>
<li style="font-weight: 400">Inform the doctor in advance and on the day of treatment about any drug allergies.</li>
<li style="font-weight: 400">Get enough rest the night before the procedure.</li>
</ul>
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<h2>Steps of Shock Wave Lithotripsy Treatment </h2>
<ol>
<li style="font-weight: 400">The patient will be positioned lying on the bed appropriately.</li>
<li style="font-weight: 400">Before and during the procedure, the patient’s blood pressure, pulse, and blood oxygen levels will be monitored.</li>
<li style="font-weight: 400">The shock waves will start gently and gradually increase in intensity. If the patient experiences severe pain, dizziness, nausea, vomiting, or excessive sweating, they must inform the doctor immediately.</li>
<li style="font-weight: 400">The procedure takes about 90 minutes, depending on the size and location of the stone and other related factors.</li>
</ol>
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<h2>Possible Side Effects after Shock Wave Lithotripsy</h2>
Generally, side effects after lithotripsy are rare and usually mild, such as:
<ul>
<li style="font-weight: 400">Blood in the urine caused by minor kidney tissue injury from broken stone fragments. This usually improves within 24 hours or a few days after treatment.</li>
<li style="font-weight: 400">Severe abdominal or back pain because broken stone fragments may block the narrower lower ureter. If the fragments are small or powdery, they will pass naturally. If a large fragment is stuck, repeated lithotripsy or endoscopic stone removal may be necessary.</li>
<li style="font-weight: 400">Fever from inflammation, as bacteria embedded in the stone may spread. This is often seen in patients with pre-existing infections and can be treated with antibiotics.</li>
</ul>
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<h2>Post-Shock Wave Lithotripsy Care</h2>
<ul>
<li style="font-weight: 400">In addition to taking prescribed medications, patients should drink plenty of water to help flush out stone fragments with urine and reduce blood in the urine. Patients with medical conditions limiting fluid intake should consult their doctor.</li>
<li style="font-weight: 400">If experiencing high fever, bright red blood in urine, dark red urine continuously, blood clots in urine, or light red urine lasting more than one week, difficulty urinating despite pain, or severe abdominal or back pain not relieved by painkillers, seek medical attention immediately.</li>
<li style="font-weight: 400">Attend follow-up appointments to evaluate treatment results as scheduled.</li>
</ul>

Shock wave lithotripsy is a treatment for stones without surgery and without general anesthesia. It is suitable for kidney stones that are no larger than 2-2.5 cm, stones in the lower pole of the kidney, and small stones in the ureter.

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Kidney Stone Treatment and Stone Dissolution with Shock Wave Lithotripsy (ESWL)

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