Die 3. Generation der ESWL-Patientenschulung

Zuletzt aktualisiert: 29. April 2026

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Es gibt Fragen von den Patienten, was und wie der Unterschied zwischen der Patientenbelehrung bei der 3^rd und 4^th der ESWL? Ich werde in diesem Thema absichtlich nur auf die 3^d Generation eingehen.

• Urologiezentrum Bangkok Krankenhaus Thailand Online buchen 02-310-3009 bhquro@bdms.co.th
• Krankenhaus Samitivej Sriracha Chonburi 088-022-1445

Wenn Sie die 4^th Generation der ESWL Patientenanweisungen einsehen möchten - bitte besuchen Sie diesen Link.

The 4^th Generation ESWL synchronizes with human breathing achieving a 98.5% stone hit rate, while the 3^rd generation misses the target 82.6% of the time in awake patients. Sedation by an anesthesiologist is used to control breathing rhythm and improve accuracy.

Post 3^rd Generation ESWL Patient Instructions

Direkt nach dem ESWL-Verfahren

• Sie werden nach leichter Sedierung vom Anästhesisten geweckt.
• After 1-2 hours of observation in the recovery room, you will be transferred to the ward for overnight observation to monitor for sedation side effects such as dizziness or nausea.

The first several days after ESWL

• Almost 100% of patients experience bloody urination caused by the shockwave effect on surrounding kidney tissue. Drink 2-3 liters of water daily to flush out residual blood.

Within 30 days after ESWL

1. Steinstresse risk 4-7% — Shattered stone fragments may accumulate in the ureter, causing flank pain or remaining asymptomatic.
2. Residual stone risk 21-59% — Fragments under 4 mm are considered unremarkable and may pass spontaneously. Regular ultrasound follow-up is recommended.
3. Stone pain risk — Shattered fragments may trigger sudden pain. Maintain high fluid intake (2-3 liters/day). Oral medication can help reduce post-ESWL stone pain.
4. Blood stream infection risk 1-2.7% — Bacteria residing in stones may enter the bloodstream. Routine antibiotics are not prescribed; fever monitoring after the procedure is recommended.
5. Major kidney bleeding <1% — Severe kidney injury is rarely reported as ESWL is the least invasive kidney stone procedure.

Long-term complications

No existing evidence supports any long-term complications from ESWL, per EAU 2020 recommendations.

If you have any questions on the 3^rd Generation ESWL procedure, please talk to your trusted urologist, or it would be my pleasure if you text me. Take care!

Sie können meine offizielle Homepage besuchen hier.

Häufig gestellte Fragen (FAQ)

Q1: What is 3rd generation ESWL and how is it different from 4th generation?

3rd generation ESWL delivers shockwaves to break kidney stones but does not synchronize with the patient’s breathing, resulting in a stone hit rate of approximately 82.6% in awake patients. 4th generation ESWL uses respiratory gating technology to synchronize shockwaves with breathing, achieving a 98.5% hit rate. For 3rd generation ESWL, sedation is used to control breathing and improve accuracy.

Q2: Is bloody urination normal after ESWL?

Yes. Bloody urination occurs in almost 100% of patients after ESWL due to the shockwave effect on surrounding kidney tissue. It is expected and not dangerous. Drinking 2-3 liters of water daily helps flush out residual blood and stone fragments. The bloody urination typically clears within a few days.

Q3: What is Steinstresse and should I be worried?

Steinstresse is a German term meaning “stone street” — a condition where shattered stone fragments accumulate in the ureter, forming a column of debris. It occurs in 4-7% of ESWL cases and can cause flank pain or remain asymptomatic. Your urologist will monitor for this with follow-up imaging and manage it appropriately if it develops.

Q4: How long does it take to know if ESWL was successful?

Follow-up imaging is typically performed 4-6 weeks after ESWL to assess stone clearance. Residual stone fragments of less than 4 mm are considered clinically insignificant and may pass spontaneously. For larger residual fragments, additional ESWL sessions or alternative stone treatment may be recommended. Regular follow-up ultrasound is advised long-term as residual stones have a 21% chance of regrowth over 5 years.

Q5: Does ESWL cause long-term kidney damage?

According to EAU (European Association of Urology) 2020 guidelines, no existing evidence supports long-term kidney damage from ESWL when performed appropriately. ESWL remains one of the safest and least invasive kidney stone treatments available. However, patients with a history of multiple ESWL sessions or pre-existing kidney disease should discuss long-term monitoring with their urologist.

If you have kidney stones and would like to explore ESWL treatment options, Dr. Soarawee Weerasopone offers specialist consultations at Bangkok Hospital Headquarters. Beratungstermin buchen.

**Haftungsausschluss:** Dieser Inhalt wurde von Dr. Soarawee Weerasopone, einem Facharzt für Urologie am Bangkok Hospital Headquarters, verfasst und überprüft. Er dient ausschließlich Bildungszwecken und stellt keine medizinische Beratung dar. Konsultieren Sie immer einen qualifizierten Mediziner, bevor Sie eine medizinische Behandlung beginnen.