Extracorporeal Shock Wave Lithotripsy (ESWL)

minimum cost

₱ 0

maximum cost

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Things you need to know

What is ESWL ?

Why do you need ESWL ?

ESWL is indicated for:

Kidney stones:
- Stones 5–20 mm in size (best for stones <10 mm; 80–85% success rate).
- Stones in kidney (renal pelvis) or upper ureter.
- Composition: Calcium oxalate (most common, 70–80%), uric acid, or struvite stones (if not too hard).
- Incidence in India: 5–15% lifetime risk; higher in hot climates (e.g., North India).
Contraindications:
- Large stones (>20 mm), staghorn stones, or stones in lower ureter (better treated with ureteroscopy).
- Pregnancy, bleeding disorders, or urinary obstruction below stone.
Associated treatments:
- Often preceded by stent placement (if stone causes obstruction).
- Followed by medical expulsive therapy (e.g., tamsulosin) to aid stone passage.
Timing:
- Performed in adults (average age 30–50 years for kidney stones); urgency depends on symptoms (e.g., severe pain, infection).

The procedure aims to fragment stones non-invasively, relieve pain and obstruction, and prevent complications like infection or kidney damage, often as an outpatient procedure with minimal downtime.

Why Do Costs Vary in Philippines?

ESWL Procedure

Before Procedure Evaluation:
- Assessment:
  - Imaging: X-ray, ultrasound, or CT to locate stone, assess size, and check for obstruction.
  - Urine test: Checks for infection (UTI must be treated first).
  - Blood tests: Kidney function (creatinine), blood sugar, clotting profile.
- Preparation: Stop blood thinners (e.g., aspirin) 5–7 days prior if safe; hydrate well; fasting 4–6 hours if sedation used.
- Consent: Risks, including bruising, are explained.
Procedure Technique:
- ESWL:
  - Performed under sedation (IV pain relief) or light general anesthesia, lasting 30–60 minutes.
  - Process:
    - Patient lies on a table; water cushion or gel applied to couple shock waves to skin.
    - Stone localized using fluoroscopy (X-ray) or ultrasound.
    - Shock waves generated (1,000–3,000 shocks, 1–2 shocks/second) by lithotripter machine; waves pass through body, focusing on stone to break it into fragments (<2–3 mm).
    - Fragments pass naturally via urine over days to weeks.
  - Post-procedure: Patient monitored for 1–2 hours; encouraged to drink water to flush fragments.
- Equipment:
  - Lithotripter: Generates shock waves (electromagnetic, piezoelectric, or electrohydraulic).
  - Fluoroscopy/ultrasound: Guides targeting.
  - Pain management: Sedation or analgesics (e.g., fentanyl).
After Procedure:
- Hospital stay: Outpatient (discharge after 1–2 hours).
- Care: Drink 2–3 liters of water daily to flush fragments; strain urine to collect stone pieces (for analysis).
- Pain management: Mild to moderate pain during fragment passage (1–2 weeks); managed with painkillers (e.g., diclofenac).
- Instructions: Avoid strenuous activity for 1–2 days; monitor for fever or severe pain.

Recovery After ESWL

Recovery Time: Same-day discharge; recovery from discomfort takes 1–2 days.
Post-Procedure Care:
- Pain: Mild to moderate colicky pain as fragments pass (1–2 weeks); managed with painkillers.
- Urine: Blood-tinged urine (hematuria) for 1–3 days; clears with hydration.
- Activity: Resume normal activities in 1–2 days; avoid heavy lifting for 1–2 days.
- Stone passage: Fragments pass in 1–4 weeks; 80–85% clear within 1 month (depends on size, location).
Follow-Up:
- Visit at 1–2 weeks to confirm stone clearance (X-ray or ultrasound).
- Repeat ESWL (10–20% of cases): If fragments remain or stone doesn’t break adequately.

Most resume normal activities in 1–2 days; full stone clearance takes 1–4 weeks. Success rate: 80–85% for stones <10 mm; 50–60% for 10–20 mm; multiple sessions may be needed for larger stones.

Risks and Complications

Procedure Risks:
- Pain (20–30%): During shock wave delivery; managed with sedation or analgesics.
- Bruising (10–20%): At shock wave entry site (back or abdomen); resolves in 1–2 weeks.
- Hematuria (30–40%): Blood in urine; usually mild, resolves in 1–3 days.
Post-Procedure:
- UTI (2–5%): Risk of infection from stone fragments; managed with antibiotics.
- Steinstrasse (5–10%): “Street of stones”—fragments block ureter; may need ureteroscopy or stent.
- Hypertension (1–2% long-term): Rare; possibly from kidney trauma.
- Failure (15–20%): Stone doesn’t break (hard stones, e.g., cystine); may need alternative (e.g., ureteroscopy).
Long-Term:
- Recurrence (30–50%): Kidney stones often recur within 5–10 years; needs dietary changes and monitoring.

Report fever, severe pain, inability to urinate, or persistent hematuria promptly.

Frequently Asked Questions (FAQs)

What causes the need for ESWL?

Kidney or ureteral stones (5–20 mm) causing pain, obstruction, or infection.

Can I avoid ESWL?

Yes, if small stones (<5 mm): Hydration and medical expulsive therapy (e.g., tamsulosin); ESWL needed for larger stones or persistent symptoms.

Is ESWL painful?

Mild to moderate discomfort during procedure (sedation helps); colicky pain during fragment passage (1–2 weeks).

How soon can I resume normal activities?

Normal activities: 1–2 days; full stone clearance: 1–4 weeks; avoid strenuous activity for 1–2 days.

Is ESWL covered by insurance in India?

Often covered (medical necessity); confirm with your provider; Ayushman Bharat often subsidizes.

Signs of complications?

Fever, severe pain, inability to urinate, or persistent hematuria.

Will all stones be cleared after one session?

Not always: 80–85% clear with one session (stones <10 mm); larger stones may need repeat sessions or alternative procedures.

Lifestyle changes post-procedure?

Hydrate (2–3 liters/day), reduce salt/oxalate intake, monitor for recurrence, and attend follow-ups.

Conclusion

Looking for Best Hospitals for ESWL

Note: we are not promoting any hospitals

We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)

click on your city and schedule your surgery now done in good hands.

City	Minimum Price (₱)	Maximum Price (₱)
Angeles City
Antipolo
Bacolod
Bacoor
Baguio
Butuan
Cagayan de Oro
Caloocan
Cebu City
Dasmariñas
Davao City
General Santos
General Trias
Iligan
Iloilo City
Las Piñas
Makati
Malolos
Manila
Muntinlupa
Parañaque
Pasay
Pasig
Puerto Princesa
Quezon City
San Fernando
San Jose del Monte
Taguig
Valenzuela
Zamboanga City

Disclaimer

This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.