Urolithiasis (urinary tract stones) is a common condition that almost anyone can experience at least once in their lifetime. According to domestic statistics, the lifetime probability of experiencing urolithiasis is approximately 8.8%, with men being about 2 to 3 times more likely to develop it than women. Recently, due to changes in diet and lifestyle, the incidence rate among women is also on the rise. It is particularly common in individuals aged 30-50, and those with obesity, diabetes, or metabolic diseases. When urolithiasis occurs, as the stone descends from the kidney along the ureter, it can cause severe flank pain, hematuria (blood in urine), vomiting, and other symptoms.
Depending on their size or location, urinary tract stones may pass naturally, but if the pain is severe or the stone is too large to pass easily, treatment is necessary. Among the available options, Extracorporeal Shock Wave Lithotripsy (ESWL) is a widely performed treatment method that is non-surgical and relatively simple for removing stones.
Extracorporeal Shock Wave Lithotripsy (ESWL) is a procedure that focuses high-energy shock waves generated outside the body onto the stone, breaking it into tiny fragments. The shock waves induce a cavitation phenomenon within the liquid, transmitting high-pressure energy. This energy precisely reaches the stone and shatters it. The shock waves are designed to cause minimal damage to surrounding tissues and are concentrated solely on the stone.
The procedure is mostly performed without hospitalization or anesthesia. Patients receive shock waves while lying on their back or side on the treatment machine. Before the procedure, analgesics are administered to reduce pain, and the patient is stabilized to prevent movement during the treatment. After precisely locating the stone using X-ray and ultrasound, shock waves are delivered at a frequency of approximately 60-90 times per minute, totaling about 2,000-4,000 shocks. The procedure typically takes 30 minutes to 1 hour, and afterward, the shattered stone fragments are allowed to pass naturally through the urine.
After lithotripsy, patients may experience mild pain at the procedure site, hematuria, and discomfort during urination, but these symptoms usually improve within 1-2 days. However, careful observation is necessary as fragments can occasionally block the ureter again, leading to a recurrence of pain. Post-procedure, anti-inflammatory analgesics and alpha-blocker medications are prescribed to reduce pain and aid stone expulsion. It is also recommended to promote stone passage by consuming 2.5-3 liters of water daily and engaging in light activities such as jumping rope.
Since the size, location, and degree of pain vary for each patient with urolithiasis, personalized treatment is crucial. Beyond just removing the stone, combining metabolic tests to improve dietary habits with regular follow-up can significantly lower the risk of recurrence.
As such, urolithiasis is a manageable condition if diagnosed accurately and treated appropriately in its early stages. If sudden flank pain, hematuria, or vomiting symptoms appear, it is advisable to visit a medical institution for examination. Above all, understanding one's body condition and consistently managing it is the first step in preventing recurrence.
Authored by Dr. Choi Ho-cheol, Director of Goldman Urology Clinic, Dongtan Branch