Urinary stones are a common urological disease that almost anyone can experience at least once in their lifetime. While generally known to be more common in men, the incidence in women has recently been on the rise due to changes in dietary and lifestyle habits. In particular, urinary stones are known to be common in individuals aged 30-50, and those suffering from obesity, diabetes, and metabolic diseases.
When urinary stones occur, as the stones descend from the kidney along the ureter, they cause symptoms such as severe flank pain, hematuria (blood in urine), and vomiting. Depending on their size and location, some urinary stones may pass naturally, but if the pain is severe or the stone is too large to pass, active treatment is necessary. Among the available treatments, extracorporeal shockwave lithotripsy (ESWL) is considered a non-surgical and relatively simple method for removing stones.
Extracorporeal shockwave lithotripsy (ESWL) is a procedure that focuses high-energy shockwaves generated outside the body onto the location of the stone, breaking it into tiny fragments. These shockwaves induce a cavitation phenomenon within a liquid medium, transmitting high-pressure energy. This energy precisely reaches the stone and shatters it. The shockwaves do not cause significant damage to surrounding tissues. They are designed to concentrate solely on the stone, ensuring a high level of safety.
Most extracorporeal shockwave lithotripsy procedures are performed without hospitalization or anesthesia. Patients receive the shockwaves 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, shockwaves are delivered 2000-4000 times at a frequency of approximately 60-90 pulses per minute. The procedure typically takes about 30 minutes to 1 hour, and after the treatment, the shattered stone fragments are encouraged to pass naturally through urine.
After lithotripsy, patients may experience mild pain at the treatment site, hematuria, and discomfort during urination. Fortunately, most of these symptoms improve within 1-2 days. Occasionally, fragments may re-obstruct the ureter, causing pain to recur, which requires careful observation. After the procedure, anti-inflammatory analgesics and alpha-blockers are prescribed to reduce pain and aid in stone expulsion. Most importantly, it is crucial to promote stone passage by consuming 2.5-3 liters of water daily and engaging in light activities such as jump rope exercises.
It is important to remember that personalized treatment is paramount because the size, location, and degree of pain vary for each patient. It is advisable not only to remove the stone but also to reduce the risk of recurrence by combining dietary habit improvement through metabolic examinations with regular follow-up observations.
Dr. Ryoo Je-man, director of Goldman Urology Seoul Station Branch, stated, “Urinary stones are a disease that can be sufficiently managed with early, accurate diagnosis and appropriate treatment.” He added, “If sudden flank pain, hematuria, or vomiting symptoms appear, it is important not to endure them but to quickly seek medical help. Above all, understanding one's own body condition and consistently managing it is the first step in preventing recurrence.”