ESWL · Extracorporeal Shockwave Lithotripsy in Bangkok

ESWL is most effective for kidney and upper ureteric stones measuring between 5-20 mm. For very small stones less than 5 mm, your body often passes them naturally without intervention. If your stone is larger than 20 mm or located in the lower ureter, other treatments like ureteroscopy (URS/RIRS) or percutaneous nephrolithotomy (PCNL) typically offer better success rates and are often recommended as primary options. We will discuss the best approach for your specific stone.

You will likely experience mild to moderate discomfort during the shockwave delivery itself. However, most of our patients receive light sedation (TIVA) and often sleep comfortably through the entire procedure. Some discomfort is common afterward as the stone fragments pass down your ureter, which can feel similar to kidney stone pain. We will provide pain management advice for this period.

No · general anesthesia is typically not required for ESWL. We commonly use TIVA (Total Intravenous Anesthesia) or light sedation, which allows you to remain comfortable and relaxed throughout the procedure. General anesthesia is usually reserved for specific situations, such as patients with severe anxiety, certain anatomical considerations, or if a combined procedure is planned. Your comfort is our priority.

Stone fragments typically begin passing within a few days and can continue for 2-6 weeks. The exact timeline depends on your stone's size and location. We schedule follow-up imaging, usually a CT scan, at 2-4 weeks post-procedure to confirm successful fragmentation and assess if any significant fragments remain. Our goal is to ensure complete stone clearance for you.

If your stone doesn’t fragment adequately or if fragments fail to pass after ESWL, we will discuss alternative treatment options. The next step is usually ureteroscopy (URS/RIRS) or percutaneous nephrolithotomy (PCNL), depending on your specific situation. We assess the fragmentation status carefully at your follow-up scan and will collaboratively plan the most effective next steps to achieve stone clearance.

ESWL has a success rate of approximately 60-80% for appropriately selected stones, meaning you can expect significant fragmentation and passage. Long-term outcomes are generally good, but there is a small risk of stone recurrence. We will discuss preventive measures to reduce this risk. Regular follow-up and lifestyle adjustments are crucial for maintaining a stone-free status and preventing future stone formation.

We offer several anesthesia options to ensure your comfort during ESWL. The most common is TIVA (Total Intravenous Anesthesia) or conscious sedation, administered by our experienced anesthesiologist, allowing you to relax or sleep. Local anesthesia can also be used in some cases. We will discuss your medical history and preferences during your consultation to recommend the safest and most effective option for you.

During your initial consultation, you will meet with our experienced urologist to discuss your symptoms and medical history. We will review any previous imaging you have, or arrange for new scans like a CT KUB. Based on this comprehensive assessment, we will explain your stone's characteristics and recommend the most suitable treatment plan, including whether ESWL is right for you. Book a consultation for a personalized quote.

We recommend arriving in Bangkok at least 2-3 days before your procedure for pre-operative assessments. You can typically fly home 1-2 days after ESWL if you are feeling well. For follow-up, we can arrange secure WhatsApp consultations to review your progress and imaging results. We aim to make your medical journey as smooth and stress-free as possible, ensuring continuity of care even after you return home.