Extracorporeal shockwave lithotripsy (ESWL) is a technique which enables the destruction of stones in the urinary system using directed ultrasonic waves. The procedure does not involve any damage to the tissue structures or invasion of endoscopic instruments. Litotripsy (Greek “lithos” means “stone” and “tribo” means “break down”) is translated, word for word, as “breaking down stones”. Radio pulses travel freely through surrounding tissues, and the transfer of energy is only achieved at the focus area, or the “action spot”. This causes gradual loosening and destruction of the crystalline lattice of a stone located in a kidney, etc.
The procedure results in relatively large stones disintegrating into several smaller fragments that are later eliminated with the outflow of urine. The most significant advantage of ESWL procedure is absence of invasion, and, consequently, prevention of any potential contamination of the patient. The first ever kidney lithotripsy operation was carried out in Germany in 1983. The first such operation to be performed in the USSR dates 1987.
Indications to urinary stone disease treatment using the extracorporeal shockwave lithotripsy technique are:
- occurrence of stones sized 0.5 to 2 cm in urinary ducts or kidneys;
- visualization of kidney stones;
- renal colics caused by kidney stones.
The effectiveness of ultrasonic kidney and renal duct lithotripsy
It is important to be aware that lithotripsy does not eliminate the cause of urinary stone disease; the procedure serves only to disintegrate already-present stones. In order to remedy the disorder, the patient needs a continuing counseling of an urinologist to prevent any future formation of stones in kidneys and urinary ducts.
A number of parameters determines the effectiveness of the therapy:
- occurrence of any obstructions (occlusions) in the urinary ducts;
- the weight of the patient (excessive weight may result in a reduced efficiency of the procedure);
- the chemical composition of kidney or urinary duct stones and their density, urinary duct infections, etc.