Introduction to Extracorporeal Shock Wave Lithotripsy
Since German doctors invented the extracorporeal shock wave lithotripter and performed the world's first extracorporeal shock wave lithotripsy in 1980, for over 30 years, this procedure has benefited countless patients with urinary tract stones worldwide. It has provided urologists with a high-safety, effective, and non-invasive method to treat stones, in addition to surgery and medication.
"Extracorporeal Shock Wave Lithotripsy" uses shock waves generated by electric or electromagnetic fields. The energy from these focused shock waves is delivered into the body through a precise positioning system to break the stones, which are then excreted with urine.
After undergoing "Extracorporeal Shock Wave Lithotripsy," patients need to drink more water, exercise appropriately, cooperate with medication, and have regular follow-ups at outpatient clinics. For stones in certain special locations, patients will be taught to use special postures to tap their backs to facilitate stone expulsion. If the stones are not sufficiently fragmented or have not been expelled after some time, a second lithotripsy or direct endoscopic removal may be necessary, depending on the urologist's assessment.
Of course, "Extracorporeal Shock Wave Lithotripsy" is not without complications: renal colic, hematuria, etc., are common complications that can mostly be treated with appropriate exercise, plenty of water, and medication. If ineffective, endoscopic treatment is used. More severe complications like infection, renal edema, or renal hematoma may require close observation and active treatment. Rare cases of kidney rupture or gastrointestinal perforation require surgical intervention.
Repeated treatments of the same kidney location with extracorporeal shock wave lithotripsy can also lead to kidney atrophy. To minimize complications, the Taiwan Urological Association and the Ministry of Health and Welfare have set many regulations for "Extracorporeal Shock Wave Lithotripsy," such as not directly using it for kidney stones larger than 2.5 cm or ureteral stones larger than 1 cm, but instead combining it with endoscopic lithotripsy, known as the "sandwich therapy." There are also strict regulations on the number of times "Extracorporeal Shock Wave Lithotripsy" can be performed to prevent its abuse.
Due to the increasing severity of global warming, urinary tract stones are no longer just prevalent in summer. Coupled with the growing number of people with the three highs (high blood pressure, high blood sugar, high blood lipids), the incidence of urinary tract stones remains high. It is recommended that those troubled by this issue reduce oil and salt in their diet, drink plenty of plain water, and have regular check-ups to prevent the recurrence of stones.
Medical Team
LU LING YIChief PhysicianCHANG LI RENAttending PhysicianTSENG KUAN FU Attending Physician
Equipment Introduction
1. Dual Positioning SystemThe positioning system has advanced from traditional three-dimensional positioning relying heavily on X-ray exposure to a dual positioning system using both X-ray and ultrasound. This not only significantly reduces radiation harm to the body but also more than doubles the efficiency of lithotripsy, reducing shock wave damage to surrounding kidney tissues. Previously, general anesthesia was required for lithotripsy, but now it is completely unnecessary, and patients can go home immediately after the procedure.
2. Ultrasound Stone Imaging Tracking and Locking TechnologyUsing ultrasound to scan stones, shock waves are automatically fired when stones enter the focus area and automatically stop when they exit, achieving nearly 100% hit rate.
3. Our hospital has introduced a dual positioning system extracorporeal shock wave lithotripter, with a hit rate twice that of other lithotripters. It not only features the latest X-ray and ultrasound dual positioning functions, significantly reducing the radiation dose received by patients, but also uses the latest lithotripsy technology to achieve non-anesthetic painless lithotripsy.
Postoperative Precautions
1. Daily intake of more than 2000~3000 c.c. of water can help expel stone fragments.
2. If hematuria and lumbar pain occur after treatment, drink more water. If large amounts of hematuria persist or pain is unbearable, unable to urinate, or fever occurs, inform medical staff immediately or return for medical consultation.
3. Engage in more jumping exercises, such as skipping rope, running, playing ball, dancing, etc.
4. Reduce oil and salt in the diet, and drink plenty of plain water.
5. Do not hold urine, as it can cause urine concentration and increase the incidence of stones.
6. Regular follow-up visits and examinations.
7. Medication: If prescribed by a doctor, take medication as directed.
