Shock Wave Lithotripsy (SWL)

Shock Wave Lithotripsy (SWL)
 
Your doctor may recommend SWL if you have a medium-sized stone in your kidney or ureter. SWL typically takes one hour and can be done as an outpatient procedure. You should be able to resume normal activities in two to three days.

The Procedure


After you are under anesthesia, your doctor uses x-rays or ultrasound to locate the stone, then targets the stone with high-energy shock waves from outside the body. The goal of the procedure is to break the stone into small fragments that can pass in the urine over the next few weeks; however, passage of the stone fragments can create pain requiring analgesics. lf large pieces remain, another treatment can be performed or the recommendation may be to proceed with an alternative treatment, such as ureteroscopy or percutaneous nephrolithotomy. SWL does not work well on hard or large stones.
If your kidney or ureter is blocked, your doctor may recommend inserting a small plastic tube, called a ureteral stent, in your urinary tract just prior to the procedure. The stent will need to be removed at a follow-up appointment.
Shock waves from outside the body are targeted at a kidney stone causing the stone to fragment.

Before Surgery

Let your doctor know:

  • All of your prescription medicines, vitamins and supplements, herbs and natural remedies, and over-the-counter drugs.
  • Any known allergies you have to medicines and the contrast agent used in some X-rays.
  • If you may be pregnant.
  • If you have any issues with bleeding (blood clotting) or any history of a bleeding disorder.

Review the pre-operative directions provided by your doctor. You may need to:

  • Schedule appointments for an electrocardiogram (EKG), X-rays, or blood and urine tests.
  • Discuss with your doctor medicines that might increase your risk of bleeding, such as aspirin, ibuprofen, warfarin, clopidogreland non-steroidal anti-inflammatory drugs. You will need to stop taking some of these medicines before the procedure.
  • Take antibiotics, if prescribed, to help prevent infection.
  • Check with your doctor on which of your regular medicines to take the morning of surgery. On that day, take these medicines with only a small sip of water.
  • Have nothing to eat or drink after midnight the night before surgery (except the sip of water with your morning medicines) unless discussed with your surgeon and/or anesthesiologist.

Arrange for a ride home

You cannot drive yourself home after surgery, so ask a family member or trusted friend to pick you up. Most hospitals and surgery centers will not allow you to take a taxi home after surgery.

After Surgery

Be aware of these common side effects:

  • Nausea and occasional vomiting.
  • Pain within the first 24 to 48 hours in your kidneys, abdomen, lower back and sides. Take medicine as prescribed.
  • Blood in your urine. The color can range from light pink to reddish and sometimes can even have a brownish hue – but you should be able to see through it. (Medications to help with burning sensation during urination can sometimes turn urine orange or blue colored.) If bleeding increases significantly, call your doctor immediately or go to an emergency room for evaluation.

If you go home with a ureteral stent:

  • Your doctor will remove the stent at a follow-up appointment, typically four to seven days after surgery, although sometimes the stent must stay in longer.
  • You may experience a feeling of fullness in your kidney while urinating, a constant need to urinate (urgency and frequency), a burning sensation during urination or when you move, and bladder muscle spasms.

Call your doctor immediately if:

  • You have a temperature greater than 100 degrees Fahrenheit or experience chills.
  • The pain medicine is not reducing your pain.
  • You cannot tolerate food or fluids.
  • You have excessive blood in your urine – red, thick, unable to see through it – or if blood clots make it difficult to urinate. (Drinking fluids helps reduce blood clots from forming in your urine.)
Call your doctor immediately if: • You have a temperature greater than 100 degrees Fahrenheit or experience chills. • The pain medicine is not reducing your pain or you are having a side effect from pain medication. • You cannot tolerate food or fluids. • You have excessive blood in your urine – red, thick, unable to see through it – or if blood clots make it difficult to urinate. (Drinking fluids helps reduce the potential for blood clots to form in your urine.)

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