Kidney Stone manipulation: ESWL
Kidney stones form in your kidneys. As stones move into your ureters (the thin tubes that allow urine to pass from your kidneys to your bladder) signs and symptoms can result. Signs and symptoms of kidney stones can include severe pain, nausea, vomiting, fever, chills and blood in your urine.
Extracorporeal shock wave lithotripsy (ESWL) is a procedure used to shatter simple stones in the kidney or upper urinary tract. Ultrasonic waves are passed through the body until they strike the dense stones. The sound waves create strong vibrations (shock waves) that break the stones into tiny pieces that can be passed in your urine. The procedure lasts about 45 to 60 minutes and can cause moderate pain, so you will be under light anaesthesia to make you comfortable.
ESWL can cause blood in the urine, bruising on the back or abdomen, bleeding around the kidney and other adjacent organs, and discomfort as the stone fragments pass through the urinary tract.
The JJ stent is inserted during the procedure to relieve swelling and promote healing and to drain any loose fragments.
These are the commoner risks. There may be other unusual risks that have not been listed here. Please ask you surgeon if you have any general or specific concerns.There are risks associated with any anaesthetic.You may have side effects from any drugs used. The commoner side effects include light-headedness, nausea, skin rash and constipation.
Factors that increase your risk of developing kidney stones include:
- Family or personal history. If someone in your family has kidney stones, you're more likely to develop stones, too. And if you've already had one or more kidney stones, you're at increased risk of developing another.
- Dehydration. Not drinking enough water each day can increase your risk of kidney stones. People who live in warm climates and those who sweat a lot may be at higher risk than others.
- Certain diets. Eating a diet that's high in protein, sodium (salt) and sugar may increase your risk of some types of kidney stones. This is especially true with a high-sodium diet. Too much salt in your diet increases the amount of calcium your kidneys must filter and significantly increases your risk of kidney stones.
- Being obese. High body mass index (BMI), large waist size and weight gain have been linked to an increased risk of kidney stones.
- Digestive diseases and surgery. Gastric bypass surgery, inflammatory bowel disease or chronic diarrhoea can cause changes in the digestive process that affect your absorption of calcium and water, increasing the levels of stone-forming substances in your urine.
- Other medical conditions. Diseases and conditions that may increase your risk of kidney stones include renal tubular acidosis, cystinuria, hyperparathyroidism, certain medications and some urinary tract infections.
Some of the above risks are more likely if you smoke, are overweight, diabetic, have high blood pressure or have had previous heart disease.
When you are discharged, take care of the following:
- You can continue with your normal daily activities (eg. Driving, sexual activities, walking, exercise & travel)
- Drink enough fluids (1-2 litres per day)
- Take your medicine as prescribed
- You can relax in a hot bath or shower if you experience discomfort
- Rest when you can
- If urine becomes blood stained, increase your fluid intake
- Make sure you attend to your follow-up appointment to remove the JJ-stent: usually within 2 weeks of stent placement if removed in theatre. +/- 2 day’s if to be removed in the rooms (your doctor will confirm whether it will be taken out in theatre or in the rooms)
- Contact your doctor if you experience any of the following:
constant, unbearable, persistent pain;
nausea or vomiting;
difficulty in passing urine;
if your stent falls out;
if you notice a significant increase of blood in the urine
You may reduce your risk of kidney stones if you:
- Drink water throughout the day. For people with a history of kidney stones, doctors usually recommend passing about 2.5 liters of urine a day. Your doctor may ask that you measure your urine output to make sure that you're drinking enough water. If you live in a hot, dry climate or you exercise frequently, you may need to drink even more water to produce enough urine. If your urine is light and clear, you're likely drinking enough water.
- Eat fewer oxalate-rich foods. If you tend to form calcium oxalate stones, your doctor may recommend restricting foods rich in oxalates. These include rhubarb, beets, okra, spinach, Swiss chard, sweet potatoes, nuts, tea, chocolate, black pepper and soy products.
- Choose a diet low in salt and animal protein. Reduce the amount of salt you eat and choose non-animal protein sources, such as legumes. Consider using a salt substitute.
- Continue eating calcium-rich foods, but use caution with calcium supplements. Calcium in food doesn't influence your risk of kidney stones. Continue eating calcium-rich foods unless your doctor advises otherwise. Ask your doctor before taking calcium supplements, as these have been linked to increased risk of kidney stones. You may reduce the risk by taking supplements with meals. Diets low in calcium can increase kidney stone formation in some people.