Kidney stones are very painful and can cause blockage of the urinary tract, leading to kidney damage. Depending on the size and location of the stone and the medical history of the patient, a doctor may recommend extracorporeal shock wave lithotripsy (ESWL) to remove the stone. Other treatment options include open surgery and ureteroscopic surgery. All of these options have potential complications that should be considered when choosing ESWL to treat kidney stones.
Persistant Stone
The most common complication of ESWL is failure to remove the stone. Data from PubMed abstracts suggest that fragments may remain in up to 20 percent of patients. If these fragments fail to pass through the ureter, another ESWL or a more invasive surgical approach may be necessary. Your doctor can give you an estimated success rate for your particular stone type.
Blocked Ureter
The "Journal of Urology" reports that in 2 to 3 percent of cases, a stone fragment left after ESWL could block the flow of urine through the ureter, the tube that carries urine from the kidney to the bladder. If urine backs up, the kidney can be damaged. This complication may require a drainage tube to be placed in the kidney, or a stent to be placed in the ureter to facilitate drainage.
Bleeding
The pulse of shock waves to the kidney can cause bleeding in or around the kidney and its capsule. This could be severe enough to require a transfusion. It is very important to tell your doctor every medication that you take, including herbs, vitamins and over-the-counter medications. You may be asked to discontinue some of these medications to decrease the risk of bleeding.
Infection
Kidney infections can occur after ESWL, particularly if the urine flow is blocked. It is important to be aware of any flank pain or fever that occurs after ESWL. Any sign of infection should be reported immediately to your physician. Most infections are easily treated with antibiotics, but treatment should not be delayed.
Kidney Damage
Damage to the kidney tubules or blood vessels may occur due to ESWL. The chances of damage are related to how many shocks are needed, the intensity of the shocks that are delivered, and the size of the kidney (small kidneys are more easily damaged). This may cause acute renal failure, or a sudden decrease in kidney function, which is usually reversible, although permanent damage may occur in rare cases.
