Endourology and ESWL for stone disease


Endourology is the specialized branch of urology; which basically deals with the closed manipulation of the urinary tract. It comprises all urologic minimally invasive surgical procedures. Endourology is generally performed with the help of small cameras and instruments which are inserted into the urinary tract, thus facilitating prostate surgery, surgery of tumors of the urothelium, kidney stone surgery, and various urethral and ureteral procedures.

Extracorporeal Shock Wave Lithotripsy (ESWL)

Extracorporeal Shock Wave Lithotripsy (ESWL) makes use of shock waves to disintegrate a kidney stone into small pieces so that they can travel more easily via the urinary tract and pass out of the body.

The Procedure

  • In this procedure, the patient lies on a water-filled cushion, and the surgeon uses X-rays or ultrasound tests to accurately identify and locate the stone. High-energy sound waves are passed through your body, thus fragmenting the stone into small pieces. This enables the small pieces of stones to pass through the urinary tract and out of the body more easily.
  • The entire process takes only about an hour and is performed under local anesthesia.
  • A stent may be placed in the ureter if you have a large stone. This allows the small stone pieces to pass easily without causing blockage to the ureter.

ESWL is generally an outpatient procedure. Following the treatment, stone fragments tend to pass in the urine for some days and this could result in mild pain.

Why it is done

ESWL is usually performed on people who are suffering from kidney stones that are causing pain or blockage of urine. Kidney stones that are between 4 mm and 2 cm in diameter are usually treated with ESWL. ESWL can be used for treating stones in the kidney or in the part of the ureter that is adjacent to the kidney.

Endourology and ESWL for stone disease

However, ESWL is not recommended if the individual is:

  • Pregnant
  • Has a bleeding disorder.
  • Has infection in the kidney or urinary tract
  • Has kidney cancer
  • Has abnormally structured kidneys or if there is problem in the functioning of the kidneys.

Risks or complications

  • Intense pain caused by the passage of fragments of stone.
  • Blockage in urine flow
  • Infection in the urinary tract
  • Bleeding on the outside of the kidney.