ESWL in Turkey, kidney stones causes, symptoms, and treatment methods in Turkey.
ESWL is a noninvasive kidney stone treatment that uses a device that emits high-energy shock waves to break up kidney stones into pieces small enough to pass through the body and remove them through urine.
About kidney stones
Most people have two kidneys, which clean your blood by filtering water and waste to produce urine.
Kidney stones can form when salts or minerals accumulate in the urine, these minerals form crystals which are often too small to be noticed and pass out of the body without harm However, crystals can accumulate inside the kidneys to form kidney stones.
Kidney stones are usually made of calcium salts, but they can also be made of other substances, including uric acid. Most stones are less than 2 mm in diameter but can be more than 2 centimeters in diameter.
Some kidney stones stay where they first formed, but some may be able to pass from your kidney into the tube that carries urine from your kidney to your bladder (ureters).
If it gets stuck there, it can cause severe pain called renal colic; depending on the location and size of the stone, it can prevent you from urinating easily and lead to infection.
Symptoms of kidney stones
About one in 10 people have kidney stones at some point, but many of these stones are so small that they don’t cause symptoms.
Stones can be very painful when they move, and large stones can get stuck in the ureter and may cause infections.
Symptoms of kidney stones include:
- Severe pain or soreness on one or both sides of your back
- Sudden waves of intense pain caused by ureteral spasms, usually in your back below your ribs, traveling around the front of your abdomen to your groin and genitals
- Blood in the urine may not be visible; if you see blood in your urine, consult your doctor
- vomiting and nausea
- The need to urinate frequently or very urgently
- Burning when urinating
- Fever
- Hyperhidrosis
- A general sense of unease
- fatigue
The pain of your kidney stones depends on the location of the stones, not their size.
These symptoms may be caused by something else, but if you have any symptoms of kidney stones, contact your doctor if you have severe pain or a high fever, as you may need urgent medical attention.
Causes of kidney stones
Kidney stones consist of a buildup of salts or minerals in the urine and are more common in men, although more women are now getting them, possibly due to lifestyle changes.
You’re more likely to develop kidney stones if you or a family member has a history of kidney stones. About half of those who have had kidney stones will develop another stone within five years. Your nephrologist may advise you to have regular checkups to see if other stones are developing.
Certain medical conditions increase your chance of developing kidney stones, including:
- High levels of calcium in the urine – sometimes this has no obvious cause but can be caused by another medical condition such as hyperthyroidism, sarcoidosis, Paget’s disease, or Addison’s disease
- Other conditions that can affect urine formation, including cystinuria, gout, cystic fibrosis, and hyperparathyroidism
- Abnormal shape or structure of the kidney or/and ureter
- Metabolic syndrome – including high blood pressure, obesity, high blood sugar, and unhealthy cholesterol levels
- Certain digestive diseases that cause diarrhea and dehydration, such as Crohn’s disease, can also affect your overall health and lifestyle. You’re more likely to develop kidney stones if you:
- Taking certain medications – for example, antiviral drugs called protease inhibitors or certain diuretics
- Take plenty of antacids, vitamin C, calcium, or vitamin D supplements
- History of urinary tract infections
- Not drinking enough water
- inactive
- Living in a hot and dry climate
- Are overweight (obese)
Kidney stone treatment in Turkey
If your kidney stones are less than 10 mm (1 cm), you may not need to remove them right away, your urologist may suggest that you try medications called alpha blockers, this is called medical expulsive therapy (MET) You get better results if the pain is well controlled and there is no kidney infection.
MET helps pass stones in the urine more quickly by relaxing the muscles in the ureters, so symptoms last less time. It is especially good for large stones.
Your doctor will likely suggest trying MET for a month or so before resorting to other treatments.
You may have mild side effects like headaches, dizziness, and fatigue.
Kidney stone removal in Turkey
One in five kidney stones will not pass without surgical treatment. ESWL is a commonly used, non-invasive procedure that breaks kidney stones into smaller fragments, making them easier to pass naturally. Your urologist will determine if ESWL is the best option based on the size, type, and location of your stone.
If a blocked ureter makes urination difficult, your doctor may recommend a stent or nephrostomy tube to relieve pressure and pain. A stent is a hollow tube that helps keep the ureter open, while a nephrostomy tube drains urine directly from the kidney.
Thanks to modern advancements, kidney stone treatments, including ESWL, are now safer and less invasive. These techniques reduce discomfort and speed up recovery, allowing patients to return to daily activities more quickly.
Why do I need extracorporeal shockwave lithotripsy (ESWL) for kidney stones?
Your doctor may recommend ESWL if you have kidney stones causing severe and persistent pain.
In many cases, kidney stones are small enough to pass naturally with urine, requiring only pain relief while waiting for them to exit the body. Sometimes, medication may be prescribed to help speed up this process.
However, if kidney stones cause intense pain that cannot be managed at home, your doctor may refer you to a hospital for further evaluation and treatment. Immediate hospital admission may be necessary if you show signs of infection, such as fever.
At the hospital, you will typically undergo a CT scan or ultrasound, which a urologist will review to determine the best course of treatment. ESWL is a widely used, non-invasive procedure that uses shock waves to break kidney stones into smaller fragments, allowing them to pass more easily through the urinary tract. If suitable, your doctor may offer ESWL as an effective treatment option for kidney stone removal.
Alternatives to ESWL in Turkey
There are alternative treatments to ESWL (Extracorporeal Shock Wave Lithotripsy) for kidney stone removal. The best option for you will depend on factors such as the size and location of the stone, your age, overall health, and whether you have undergone previous treatments.
These are the main alternative methods:
- Observation: If the kidney stones are small and not causing complications, painkillers may be enough while waiting for them to pass naturally.
- Medical Expulsive Therapy (MET): For stones smaller than 10 millimeters (1 centimeter), medications can help speed up the stone’s passage through urine.
- Ureteroscopy: This procedure uses laser lithotripsy to break up stones. A stent may be placed in the ureter to prevent blockage from stone fragments.
- Percutaneous Nephrolithotomy (PCNL): A keyhole surgery used to remove larger kidney stones when other treatments have not been effective.
ESWL for Kidney Stone Removal
ESWL is one of the most advanced and non-invasive methods for treating kidney stones. It uses shock waves to break stones into smaller fragments that can pass naturally through urine. Since ESWL does not involve incisions or instruments placed inside the body, hospital stays are shorter, and there is a lower risk of complications compared to surgical procedures.
While some surgical methods may have a higher success rate than ESWL, they are more invasive. It is also important to be aware of possible ESWL complications, such as pain, bleeding, infection, or the need for additional treatments if the stones do not break completely. Your doctor will help determine whether ESWL is the best option for you.
Preparing for non-invasive extracorporeal shockwave lithotripsy (ESWL)
Your doctor will explain how to prepare for ESWL and provide important guidelines for the procedure. If you smoke, it’s best to stop before ESWL, as smoking may increase the risk of complications.
ESWL is usually performed as an outpatient procedure, meaning you can go home the same day. However, you won’t be able to drive yourself afterward, so be sure to arrange for someone to take you home.
Anesthesia is typically not required for ESWL, so you will remain awake during the procedure. You may receive a sedative to help you relax, which could make you drowsy. Additionally, a painkiller will be given to minimize discomfort, along with an injection of antibiotics before the procedure.
You will usually need to stop eating two to four hours before ESWL, but you can continue drinking clear liquids such as water, black tea, or coffee. If you take any medications, especially blood thinners, consult your doctor in advance to determine whether you should stop or continue taking them.
What are the steps of extracorporeal shock wave lithotripsy (ESWL) in Turkey?
ESWL is typically performed by a specialized doctor called a urologist. Using a device known as a shock wave generator, the procedure is conducted externally, without the need for surgery. The entire process usually lasts between 30 minutes and an hour, depending on the size of the kidney stones.
During ESWL, you will be asked to lie on a treatment table with your lower back positioned toward the machine. Your doctor will apply a gel to your skin to help the shockwaves travel effectively. Using ultrasound or X-rays, your doctor will precisely locate the kidney stones before activating the shock wave generator. This device sends pulses of shockwaves through your skin to break the stones into smaller fragments.
It is important to remain as still as possible during ESWL to ensure the shockwaves are accurately targeted. You may feel a stinging sensation on your back from the shockwaves, and some people experience deeper pain in the kidneys.
Multiple ESWL sessions may be necessary for larger stones to break into pieces small enough to pass naturally through the ureter and bladder.
What to expect after the ESWL procedure?
You will usually be able to go home a few hours after ESWL. If you have been given a sedative, you may feel a bit groggy for some time. For this reason, it is safest to avoid driving for 24 hours after the procedure.
Before you leave, your doctor will provide you with important ESWL recovery guidelines and details about follow-up appointments. You may be prescribed painkillers to manage any discomfort and antibiotics to reduce the risk of infection.
Recovering from ESWL
Once you get home after ESWL, it’s best to rest for the remainder of the day. Most people can resume normal activities quickly, but recovery may depend on the size of the stones and how the procedure went.
You will need to wait for the kidney stone fragments to pass naturally in your urine. This process can take several days to weeks. To help flush your urinary system and reduce the risk of bleeding and infection, drink plenty of fluids—about twice as much as usual. Your doctor may also ask you to collect urine for 24 hours for laboratory analysis.
Passing stone fragments can be painful, so take any prescribed painkillers or over-the-counter pain relievers if advised by your doctor. If you experience severe pain, high fever, increased bleeding, or difficulty urinating, contact the hospital immediately.
You will typically have a follow-up appointment about six weeks after ESWL. Your doctor may order an X-ray to check whether all kidney stone fragments have passed. If any remain, further treatment may be necessary.
Side effects of ESWL
Unwanted but mostly temporary side effects you may experience from the procedure, side effects of extracorporeal shockwave lithotripsy include the following:
- Pain and discomfort as stone fragments pass through the urinary tract
- A small amount of blood and fragments of stones in the urine This can last for several days
- Bruising and sores in your skin where you were given the treatment This usually goes away within seven days
Complications of extracorporeal shock wave lithotripsy
Complications are issues that can occur during or after treatment. The most common complications of extracorporeal shock wave lithotripsy include
- A urinary tract infection can develop as stones break. If you have symptoms of an infection, such as fever, pain, and trouble urinating, contact your doctor.
- Severe bleeding, a small amount of blood in the urine, is to be expected, but if there is a lot of blood or blood clots, talk to your doctor.
- A blockage in the ureter (the tube from the kidneys to the bladder). Sometimes, pieces of broken stones accumulate here and get stuck. You may need surgery to remove them.
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