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Yeh kya hai aur kyun kiya jata hai
Aik machine shock waves jild aur jism se guzaarti hai jo pathri par markooz hoti hain. Yeh waves pathri ko chhoti tukron mein todne ke liye kaafi taaqatwar hoti hain lekin aas paas ke naram tissue se guzar jati hain. Pathri ko machine ke saath milane ke liye X-ray ya ultrasound istemal hota hai.
ESWL gurde aur ureter ke upar hisse ki munasib pathrion ke liye istemal hoti hai. Is mein cut nahi lagta aur aam tor par aap ko sulane wali bay-hoshi nahi di jati. Yeh har pathri ke liye munasib nahi hoti: bohat sakht ya bari pathrian, aur gurde ke kuch hisson ki pathrian kam jawab deti hain, aur kuch logon ko yeh nahi di ja sakti (neeche dekhein). Aap ka urologist ESWL ka muqabla ureteroscopy (URS), gurde ki keyhole surgery (PCNL) aur intezar se karega (dekhein gurde ki pathri ki guide).
Procedure se pehle
- Scans: aam tor par pathri aur us ki jagah dikhane wala scan pehle ho chuka hota hai (dekhein CT scans aur KUB X-ray). Unhein saath layein.
- Peshab ka test pehle hota hai. Peshab ke infection ka shock wave ilaaj se pehle ilaaj hota hai (dekhein peshab ke tests ki guide).
- Kin ko nahi di ja sakti: ESWL hamal mein, ya agar peshab ke infection ka ilaaj na hua ho ya pathri ke neeche rukawat ho to istemal nahi hoti. Khoon behne ke masail aur khoon patla karne wali dawaon ko pehle theek karna zaroori hai. Dono ke baare mein team ko batayein.
- Dard ka ilaaj: aap ko dard kam karne ki dawa, aur kabhi sedation, di jayegi. Khaane peene ke baare mein jo hidayaat milein un par amal karein.
- Aap se razamandi (consent) maangi jayegi. Yeh poochhne ka waqt hai ke kitne sessions ki zaroorat par sakti hai.
- Qeemat aur yeh kahan hogi, yeh bhi poochh lein.
Procedure ke dauran
Aap aik table par lette hote hain aur pathri ke upar jild par paani se bhara gaddi numa cushion lagaya jata hai. Pathri ko X-ray ya ultrasound se milaya jata hai aur shock waves musalsal dene shuru kiye jate hain. Aap ko thap thap ki awaaz aur halka thap thapane ya jhatke ka ehsaas hoga.
Session aam tor par aik ghantay se kam ka hota hai. Zyadatar log usi din ghar chale jate hain. Aap se kaha ja sakta hai ke jo tukre nikalein unhein sambhaal kar rakhein taake un ka test ho sake.
Procedure ke baad
- Peshab mein khoon chand din tak aam hai. Bohat paani peeyein, siwaye is ke ke aap se kam karne ko kaha gaya ho, is se tukre nikalne mein madad milti hai.
- Tukron ke nikalne par dard. Yeh lehron ki tarah aa sakta hai, asal pathri ke dard (colic) jaisa, aur aam tor par theek ho jata hai. Aam dard kam karne wali dawayein madad karti hain, aur kabhi ureter ko dheela karne wali dawa bhi di jati hai.
- Jild par neel ya sozish jahan shock waves dakhil hui hon aam hai.
- Tukron ka nikalna: chhote tukre aur ret jaisi kirchiyan kuch din se kuch haftay mein nikalti hain. Aam tor par nali ki zaroorat nahi hoti.
- Halke kaam par jaldi wapas aa jayein, aur bhaari kaam aur kasrat ke baare mein team se poochh lein.
Mumkina khatrat
- Aam: peshab mein khoon, tukron ke nikalne par dard, aur jild par neel ya sozish.
- Kam aam: peshab ka infection, bache hue tukre jin ke liye doosra session ya koi aur ilaaj chahiye, aur tukron ka jama ho kar ureter ko band kar dena.
- Bohat kam: gurde ke aas paas khoon behna jis ke liye hospital mein ilaaj chahiye ho sakta hai, ya gurde ya qareeb ke angon ko chot.
Har pathri aik hi session mein poori nahi tootti. Kabhi doosra session ya koi aur ilaaj jaise URS darkaar hota hai.
Follow-up aur pathri ke nateeje
- Jaanch ka scan: aam tor par baad mein scan ya X-ray tay hota hai taake dekha jaye ke kitni pathri saaf hui.
- Mazeed ilaaj: agar pathri baqi ho to doosra session ya koi aur procedure tay ho sakta hai.
- Pathri ka tajzia: agar aap aik tukra sambhaal kar rakhein to us ka test ho sakta hai ke pathri kis cheez ki thi (dekhein 24 ghante ka peshab aur pathri ka tajzia).
- Nayi pathri se bachao: kaafi paani peena sab se ahem qadam hai. Aap ka urologist mazeed mashwaray de sakta hai.
Fauran madad kab lein
Agar in mein se koi bhi ho to fauran qareebi hospital ke emergency department jayein, ya us unit se raabta karein jis ne ilaaj kiya:
- Bukhar, kapkapi ya bohat bimar mehsoos karna (dekhein urinary tract infection guide).
- Pehlu ya kamar mein shadeed dard jo aam dard kam karne wali dawaon se kam na ho, ya dard ke saath ulti.
- Aap peshab nahi kar pa rahe, ya bohat kam kar rahe hain (dekhein urinary retention guide).
- Zyada khoon behna, gehra surkh peshab ya lothray jo peshab rok dein.
Chand din tak peshab mein khoon, jild par neel, aur tukron ke nikalne par pehlu mein dard aam baat hai aur emergency ki zaroorat nahi.
Aam sawalaat
Kya is mein dard hota hai?
Aap ko dard kam karne ki dawa, aur kabhi sedation, di jati hai. Zyadatar log thap thapane ka ehsaas aur kuch takleef mehsoos karte hain. Sab se takleefdeh hissa aksar baad mein hota hai jab tukre nikalte hain.
Kya mujhe sula diya jayega?
Aam tor par nahi. ESWL aam tor par dard ki dawa, aur kabhi sedation, ke saath hoti hai. Team aap ko batayegi ke kya umeed rakhni hai.
Kya cut ya doorbeen hoti hai?
Nahi. Shock waves jild se guzarti hain, is liye na cut lagta hai na doorbeen jati hai.
Kya aik session kaafi hoga?
Kabhi, lekin hamesha nahi. Kuch pathrion ko aik se zyada session ya koi aur ilaaj chahiye hota hai.
Kaam par kab wapas ja sakta hoon?
Bohat se log aik do din mein halke kaam par wapas aa jate hain. Bhaari kaam aur kasrat ke baare mein team se poochh lein.
Kya pathri dobara ban sakti hai?
Haan, pathri dobara ban sakti hai. Kaafi paani peena aur urologist ke mashwaray par amal karna imkaan kam karta hai (dekhein gurde ki pathri ki guide).
What it is and why it is done
A machine sends shock waves through the skin and body that are focused on the stone. The waves are strong enough to break the stone into small pieces but pass through the soft tissue around it. X-ray or ultrasound is used to line up the stone with the machine.
ESWL is used for suitable stones in the kidney and in the upper part of the ureter. It needs no cut and usually no anaesthetic that puts you to sleep. It may not be suitable for every stone: very hard or large stones, and some positions in the kidney, respond less well, and some people cannot have it (see below). Your urologist will compare ESWL with ureteroscopy (URS), keyhole kidney surgery (PCNL) and waiting (see the kidney stones guide).
Before the procedure
- Scans: you will usually have a scan to show the stone and its position (see CT scans and the KUB X-ray). Bring them with you.
- A urine test is done first. A urine infection is treated before shock wave treatment (see the urine tests guide).
- Who cannot have it: ESWL is not used in pregnancy, or if there is an untreated urine infection or a blockage below the stone. Bleeding problems and blood-thinning medicine must be sorted out first. Tell the team about both.
- Pain relief: you will be offered pain relief, and sometimes sedation. Follow any instructions about eating and drinking.
- You will be asked for consent. This is the time to ask how many sessions may be needed.
- Ask about the cost and where it will be done.
During the procedure
You lie on a table with a water-filled cushion against the skin over the stone. The stone is lined up using X-ray or ultrasound, and shock waves are given in a steady series. You will hear a tapping sound and feel a tapping or flicking sensation.
The session usually lasts under an hour. Most people go home the same day. You may be asked to keep the pieces that pass, so they can be tested.
After the procedure
- Blood in the urine is common for a few days. Drink plenty of water unless told otherwise, which helps flush the pieces out.
- Pain as pieces pass. This can come in waves, a bit like the original stone pain (colic), and usually settles. Simple pain relief helps, and sometimes a medicine that relaxes the ureter is added.
- Bruising or soreness on the skin where the shock waves entered is common.
- Passing the pieces: small pieces and gritty sand may pass over days to weeks. A tube is not usually needed.
- Return to light activity quickly, and ask the team about heavy work and exercise.
Possible risks
- Common: blood in the urine, pain as pieces pass, and bruising or soreness on the skin.
- Less common: a urine infection, leftover pieces that need a second session or another treatment, and a build-up of pieces blocking the ureter.
- Rare: bleeding around the kidney, which may need hospital care, or injury to the kidney or nearby organs.
Not every stone breaks completely in one session. A second session, or a different treatment such as URS, is sometimes needed.
Follow-up and stone results
- Check scan: a scan or X-ray is usually arranged afterwards to see how much of the stone has cleared.
- More treatment: if stone remains, a second session or another procedure may be planned.
- Stone analysis: if you keep a piece, it can be tested to find out what the stone is made of (see 24-hour urine and stone analysis).
- Preventing new stones: drinking enough water is the main step. Your urologist may suggest more.
When to seek urgent help
Please go to the nearest hospital emergency department, or contact the unit that did your treatment, if any of these happen:
- Fever, shivering or feeling very unwell (see the urinary tract infection guide).
- Severe pain in the side or back that usual pain relief does not settle, or pain with vomiting.
- You cannot pass urine, or are passing very little (see the urinary retention guide).
- Heavy bleeding, bright red urine or clots that block the flow of urine.
Blood in the urine, bruising on the skin, and an ache in the side as pieces pass are expected for a few days and do not need an emergency visit.
Common questions
Does it hurt?
You are given pain relief, and sometimes sedation. Most people feel a tapping sensation and some discomfort. The most painful part is often afterwards, as pieces pass.
Will I be put to sleep?
Usually not. ESWL is normally done with pain relief, and sometimes sedation. The team will tell you what to expect.
Is there a cut or telescope?
No. The shock waves pass through the skin, so there is no cut and no telescope.
Will one session be enough?
Sometimes, but not always. Some stones need more than one session, or a different treatment.
How soon can I go back to work?
Many people return to light work within a day or two. Ask the team about heavy work and exercise.
Can the stone come back?
Yes, stones can come back. Drinking enough water and following your urologist's advice lower the chance (see the kidney stones guide).