Emergency Number



What is Kidney Stone?


A kidney stone is a crystal or solid lump in the urinary tract formed by substances in urine. They are the result of super concentration of chemicals in the urine that forms solid crystals called “Stones”.
Approximately 75% Kidney Stones are calcium oxalate, 10 to 12% are uric acid stones are belived to be due to acidic urine, magnesium ammonium phosphate stones are belived to be associated with infection by urea splitting bacteria. Cystine stones are rare.


 Stone Types:

  • Renal
  • Ureteric
  • Bladder
  • Urethral


 What are the Symptoms of Kidney Stones or Urinary Stones ?

  • Sudden pain usually at night or in early morning.
  • Pain from upper back to lower abdomen and groin.
  • Nausea and / or vomiting
  • Frequency of urination.
  • Burning in urine.
  • Occasionally blood in urine.
  • Chills and fever.


 What causes a Kidney Stone?

  • High level of calcium, uric acid, etc. In blood.
  • Drinking hard water
  • Chronic dehydration
  • Obstruction to urine flow
  • Local infection
  • A genetic predisposition


 What is ESWL?


ESWL means Extra corporeal Shock Waves Lithotripsy. Various Methods of Removal of Renal Stones :


(1) ESWL

ESWL is a non invasive procedure of crushing stones with shock waves. It is an alternative better option to surgical removal of stones less than 2cms. Recent trends indicates that about 9 out of 10 patients with stones in kidney are candidates for ESWL. 

Here lithotripsy shock waves are generated out side the body and are focused on stone using IITV and / or sonography guidance. This shock waves hit the targeted stone and in this way the stone gets fragmented and then passes in urine.


(A) PCNL for large renal stones. 

(B) Ureteroscopy for ureteric stones. 

(C) Cystolitholapaxy for bladder stones.





 Advantages of ESWL

  • Faster recovery time
  • Day care procedure so no need for hospitalization.
  • Generally no need for anaesthesia.
  • LESS pain.
  • Less expensive than other alternatives
  • It avoids inherent complications of surgical procedure.


 Indications of ESWL:

  • Any patient with Urinary Stones
  • 70% of Urinary Stones ESWL monotherapy
  • 15% Combination therapy for complex stones
  • 15% Endoscopic or open surgery


 Site of stones:

  • Renal
  • Upper Ureteric
  • Middle Ureteric (Prone Position)
  • Lower Uretic
  • Bladder
  • Rebels


 Contraindications of ESWL:

  • Medical
  • Pregnancy
  • Uncorrected Bleeding Dis-orders
  • Aortic or Renal artery Aneurysin
  • Pacemaker (Stendby Cardiologist)



  • Problem of Stone Location
  • Patient Size
  • Morbid Obesity
  • Skeletal abnormality
  • Ectopic Kidneys
  • Radiolucent Stone



  • Distal obstruction
  • Severe anatomical or function alteration
  • Large stone burden
  • Acute Urinary Track Infection



  • Good Clinic judgement comes from experience and experience comes from bad clinical judgement so we cant say any thing before clearance
  • Limitations Experience overreacting the Limitations
  • Stone composition
  • Size of the Stone (We can do Lithotripsy if stone size is more than 2.5 c.m.)
  • Anatomic Alteration
  • Lower calyceal Stone (up to 1.5 c.m.)


 How to select the patient for ESWL


Renal pelvic stone

  • Up to 1.5 c.m. (95 % result)
  • 1.5 to 2.5 c.m. ESWL with Dj Stent (70% Result)
  • For more than 2.5 c.m. stone PCNL is ideal procedure.


 Proximal Urertic Stone (above SI joint)

  • ESWL in Situ
  • Push back with ESWL
  • By pass stenting with ESWL
  • URS



Distal Ureter (below SL joint)

  • URS
  • ESWL


 Per ESWL Evaluation

  • History and Physical Examination
  • Drug History
  • Medical History(Hypotension, Hypertension, Hydronephrosis, Blood Pressure)
  • C.B.C. Urine
  • P.T.
  • X-ray- KUB
  • IVP


 Post Procudre Care

  • Admissions are not mandatory even for mediclaim
  • During the Treatment
    IV fluids
    IV Antibiotics SOS (Obstruction or Infection)
  • Plenty of oral fluids (200 ml/hr)
  • Diet
  • Oral Drugs
  • Stone fragment collection & Stone Analysis
  • Follow up-After 15 to 20 Days


 Post Procedure complections

  • Pain
  • Hematuria
  • Fever
  • Stone Stress
  • Chances of Failure


 Treatment of Failure

  • In case of Failure, service will given by us at free of charge
  • PCNL
  • URS
    (only Anesthesia Charges & Drug caharges are to be given)



  • No Renal Function Deterioration
  • No Statistically significant increase in cadence of Hypertension
  • Safe in Pediatric age Group




To Patients
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To Doctors
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