Term Lithotripsy has been derived from Greek language. Litho means stone and tripsy means procedure of breaking. LITHOTRIPSY is NON INVASIVE AND SCIENTIFIC procedure to disintegrate kidney, ureteric and urinary bladder stones without surgery.
 

Scientific term used for Lithotripsy is ESWL. It stands for Extracorporeal Shock Wave Lithotripsy – A procedure of breaking stone by shockwaves generated from outside the body.
 

ESWL was invented in February, 1980, at Munich (Germany). Since then it is widely and successfully used all over the world. At present it is the most superior, safe, modern and scientific modality for stone treatment. More than 10000 Lithotripsy machines are working world wide at present. It is approved by Health Authorities all over the world.
 

Shock Wave is an energy front. It is produced by an abrupt high magnitude electrical discharge in various types of media. In water media, it is called Electro hydraulic, in magnetic field Electromagnetic and in ceramic crystals Piezoelectric.
 

Major constituent of all human tissues is water (90%). Shockwaves pass through these tissues without any resistance. (Impedance) A Stone offers high resistance to Shockwaves due to its higher density. Due to this high Impedance it absorbs energy from shockwaves. This disintegration is enhanced by adjusting the stone on the focal point of shockwave generation source.
 

Single and multiple stones of various chemical compositions and sizes can be treated. It is very useful for residual and recurrent stones.
 

There are only few contraindications for ESWL.
      1)   Pregnancy
      2)   Bleeding Disorders.
In cases where obstruction and infection are present along with the stone, they should be treated prior to the stone. It should be avoided in non functioning kidney.
 

Large stones when broken by ESWL can cause problems during clearance. They can block ureter and cause obstruction. They may remain stagnant in dependent calyces. Larger stone may require multiple ESWL sittings. Ideal treatment for such stones is percutaneous removal of stone. (PerCutaneously NephroLithotomy – PCNL)
 

Ureterorenoscopy (URS) is a simple and safe procedure. A slender 6F scope is passed through urethra in ureter. Stones can be broken or extracted under vision. For stones in lower ureter and at times in mid ureter, URS is treatment modality of choice.
 

Once the final diagnosis of the stone is made, only routine blood and urine investigations are required. Patient has to be nil by mouth for four hours.
 

Pain threshold differs from patient to patient. Majority of the cases can be done with simple I. V. Sedation. Sensitive patients and children need short pentothal or ketamine.
 

Single treatment sitting takes around 45 minutes. 1 cm stone usually breaks in single sitting. Larger stones may require more than one sitting at an interval of around 7-10 days. No extra charge is taken for these sittings.
 

Treatment cost depends on the size of the stone. Larger stones require more number of shockwaves, consume more electricity and machine spares. Treatment cost increases with the size of stone. It is INCLUSIVE OF THE DOCTOR FEES, ANESTHESIA IF REQUIRED, POST TREATMENT FOLLOW UP AND DIETARY ADVICE TO PREVENT RECURRENCE.