Urinary stones can be treated without surgery.

Have you ever wondered how those hard lumps that we know as “stones” are formed?

Simply put, stones are caused by the accumulation of waste in our body. For example, in the urinary system, when we do not completely empty our bladder, urine remains in the bladder, leading to sedimentation that gradually grows into stones in various organs 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, allowing more sediment to accumulate.

Non-surgical treatment options for stones

Of course, when stones form in the body, the commonly used targeted treatment is surgery to remove the stones. However, every surgery carries risks, and many patients are anxious when they learn they need surgery. This has led to the development of alternative technologies for treating urinary stones without surgery.

Extracorporeal Shock Wave Lithotripsy (ESWL) is a treatment that uses sound waves transmitted through the skin directly to the stone, causing shock waves that crack and break the stone into small pieces or powder. This allows the stone fragments to pass out with urine without surgery, leaving no wounds, causing no damage to tissues, and is very safe.

Which stones are suitable for ESWL treatment?

1. Kidney stones no larger than 2-2.5 cm (except for stones located at the lower pole of the kidney, which should not exceed 1.5 cm)
2. Ureteral stones in any position no larger than 1 cm

Some types of stones that are difficult to break, such as cystine stones or calcium oxalate monohydrate stones, may require repeated lithotripsy or may fail to break and need other treatments.

Steps of shock wave lithotripsy

1. The patient will undergo real-time X-ray imaging with a monitor to clearly locate the stone.
2. The doctor will use a lithotripter machine to generate and send energy waves through the skin to the stone’s location.
3. This treatment requires a specially designed patient bed with a recessed area at the waist to allow the lithotripter to send waves from underneath the bed.
4. The procedure takes a short time (about 1-1.5 hours).

Limitations of shock wave lithotripsy

1. Stones that are too large
2. Patients with bacterial infection and inflammation in the urinary tract
3. Patients with unstable or uncontrolled blood pressure
4. Patients with abnormal bleeding conditions, blood clotting problems, or those taking blood thinners
5. Patients with urinary tract obstruction below the stone
6. Obese patients
7. Pregnant patients
8. Patients with abdominal aneurysms

Possible complications

1. Red or bloody urine, which can occur within 24 hours after lithotripsy but usually fades after 2-3 urinations.
2. Fever or increased infection due to bacteria embedded in the stone spreading, often seen in patients with pre-existing infections, which can be treated with antibiotics.
3. Severe abdominal or back pain caused by stone fragments blocking the ureter, although these fragments usually pass on their own.
4. Minor bruising of adjacent organs such as the skin in contact with the lithotripter, intestines, arteries, or veins.

Since shock wave lithotripsy does not address the root cause of stone formation, patients may experience recurrent stones. Treating the underlying cause is the best approach. Patients should see a specialist for diagnosis and have regular annual check-ups, especially of the lower urinary tract, including urine tests and abdominal X-rays of the kidneys and bladder, to detect the disease early and receive timely treatment.