Shock Wave Lithotripsy (SWL)

Shockwave Lithotripsy, also known as SWL, is a type

of stone surgery where sound waves are

directed towards the stone to break up the stone into

smaller fragments, which then the patient

can pass on their own.

Now, I think shockwave is often indicated

for smaller and favorably located stones.

So when we say smaller, usually in one less

than one centimeter.

And location wise,

it’s usually best if it’s in the ureter or in the top

or middle portion of the kidney.

For those types of kidney stones

the surgery can be quite effective.

Now, shockwave has some clear advantages compared

to other stone surgeries.

The first and foremost is that it’s non-invasive, right?

So it’s, it’s the least invasive of all the stone surgeries,

and so there’s no cuts, no cameras, no lasers

that have to go inside the patient.

And, um, you know, for this, I think

because of that there’s often, uh, a faster recovery

for these types of patients.

So, you know, they certainly get to go home the same day

and, um, they’re often back to work, you know, faster than

for the other stone surgeries.

Now, the other clear advantage for shockwave is that

it has the lowest risk for complications.

And so, you know, compared to the other stone surgeries,

you know, it’s just the, it is very low likelihood

of you having any problems with this type of surgery.

And then the third, I think, you know,

especially when you talk to patients who’ve had multiple

types of kidney stone surgery,

you don’t usually need a stent

with a shock wave lithotripsy.

And that’s great for those patients

because you know, those, that’s a very bothersome

and uncomfortable experience to live with those

straw like tubes with the curls on each end.

So when you talk about shock wave,

there’s some clear advantages

and there’s also some clear disadvantages.

And the main one for shockwave, for disadvantages is

that it might just not work, you know, the stones

and, uh, the type of anatomy can make a difference in

how effective shockwave actually is.

And so for some stones, they’re just resistant

to the shockwaves, and so the energy doesn’t do much

to the stones, and the patients are often left with

residual stones or even the same type

of stone burden that they started with.

And so for those patients, especially those who want

to have a definitive surgery in one surgery

and rather not have to go through multiple surgeries,

shockwave is probably not for them.

And then, you know, secondly, I guess for those patients

who have more tissue who are more obese, the shockwave,

effectiveness is not as high.

And that’s makes sense

because the energy required to penetrate that tissue is

is just not going to be

as effective when there’s more tissue present.

Thanks.