3rd Generation ESWL Patient Instructions

Q: 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 breathing, resulting in an 82.6% hit rate in awake patients. 4th generation ESWL uses respiratory gating to synchronize with breathing, achieving 98.5% accuracy. Sedation is used with 3rd generation ESWL to control breathing and improve results.

Q: 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.

Q: What is Steinstresse and should I be worried?

Steinstresse means stone street in German — 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 with follow-up imaging and manage appropriately.

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

Follow-up imaging is typically performed 4-6 weeks after ESWL. Residual fragments under 4 mm are considered clinically insignificant and may pass spontaneously. Regular follow-up ultrasound is advised as residual stones have a 21% chance of regrowth over 5 years.

Q: Does ESWL cause long-term kidney damage?

According to EAU 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.

បានធ្វើបច្ចុប្បន្នភាពចុងក្រោយ៖ ខែមេសា 29, 2026

Soaravy Weerasopone, ឯកទេសប្រព័ន្ធទឹកនោម

ជ្ឈមណ្ឌលកណ្តាលនៃមន្ទីរពេទ្យបាងកក។

មន្ទីរពេទ្យ Samitivej Sriracha, Chonburi

ទំនាក់ទំនង LINE

មានសំណួរជាច្រើនដែលអ្នកជម្ងឺបានសួរអំពីភាពខុសគ្នារវា ឧបករណ៍ជំនាន់ទី៣ និងជំនាន់ទី៤? ក្នុងប្រធានបទនេះខ្ញុំនឹងធ្វើការបកស្រាយតែទៅលើឧបករណ៍ជំនាន់ទី៣ តែប៉ុណ្ណោះ

មជ្ឈមណ្ឌលផ្នែកជម្ងឺប្រព័ន្ធទឹកនោមនៃមន្ទីរពេទ្យបាងកក ប្រទេសថៃ។ កក់លេខរៀងការណាត់ជួបតាម online 02-310-3009 bhquro@bdms.co.th
មន្ទីរពេទ្យ Samitivej Sriracha ខេត្តឈុនបូរី។ 088-022-1445

ប្រសិនលោកអ្នកចង់មើលសារឡើងវិញលើសេចក្តីណែនាំសម្រាប់អ្នកជម្ងឺលើឧបករណ៍ជំនាន់ទី៤ – សូមលោកអ្នកចុចលើដំណរនេះ។

The 4^ទី 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

ភ្លាមៗបន្ទាប់ពីបាញ់ក្រួស ៖

អ្នកនឹងត្រូវបានដាស់ដោយគ្រូពេទ្យជំនាញខាងថ្នាំសណ្តំ បន្ទាប់ពីប្រើថ្នាំងងុយគេងកម្រិតមធ្យម។.
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.

ការនោមបង្ហូរឈាម - ស្ទើរតែ 100%

Within 30 days after ESWL

Steinstresse risk 4-7% — Shattered stone fragments may accumulate in the ureter, causing flank pain or remaining asymptomatic.
Residual stone risk 21-59% — Fragments under 4 mm are considered unremarkable and may pass spontaneously. Regular ultrasound follow-up is recommended.
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.
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.
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!

អ្នកអាចចូលមើលគេហទំព័រផ្លូវការរបស់ខ្ញុំ នៅទីនេះ.

សំណួរដែលសួរញឹកញាប់

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. កក់ការពិគ្រោះយោបល់.

ការបដិសេធ៖ ខ្លឹមសារនេះត្រូវបានសរសេរ និងពិនិត្យដោយលោកវេជ្ជបណ្ឌិត Soarawee Weerasopone ដែលជាគ្រូពេទ្យឯកទេសខាងប្រព័ន្ធទឹកនោមដែលមានវិញ្ញាបនបត្រនៅទីស្នាក់ការកណ្តាលមន្ទីរពេទ្យបាងកក។ វាត្រូវបានបម្រុងទុកសម្រាប់គោលបំណងអប់រំតែប៉ុណ្ណោះ ហើយមិនមែនជាដំបូន្មានផ្នែកវេជ្ជសាស្ត្រទេ។ តែងតែពិគ្រោះជាមួយអ្នកជំនាញថែទាំសុខភាពដែលមានសមត្ថភាពមុនពេលចាប់ផ្តើមការព្យាបាលណាមួយឡើយ។.

សរសេរ និងពិនិត្យផ្នែកវេជ្ជសាស្ត្រដោយ៖ វេជ្ជបណ្ឌិត សូរ៉ាវី វីរ៉ាសូផូន (វេជ្ជបណ្ឌិត ប៉ុម) — អ្នកជំនាញខាងប្រព័ន្ធទឹកនោមដែលមានវិញ្ញាបនបត្រពីក្រុមប្រឹក្សាភិបាល ទីស្នាក់ការកណ្តាលមន្ទីរពេទ្យបាងកក។ អ្នកស្រាវជ្រាវអន្តរជាតិ៖ មហាវិទ្យាល័យវេជ្ជសាស្ត្របៃឡ័រ (សហរដ្ឋអាមេរិក) · សាកលវិទ្យាល័យជូនថេនដូ (ជប៉ុន) · មន្ទីរពេទ្យអនុស្សាវរីយ៍ឆាងហ្គុង (តៃវ៉ាន់)។.

វេជ្ជបណ្ឌិត Soarawee Weerasopone

លោកវេជ្ជបណ្ឌិត សូរ៉ាវី វីរ៉ាសូផូន (លោកវេជ្ជបណ្ឌិត ប៉ុម) គឺជាគ្រូពេទ្យឯកទេសខាងប្រព័ន្ធទឹកនោមដែលមានវិញ្ញាបនបត្រនៅទីស្នាក់ការកណ្តាលមន្ទីរពេទ្យបាងកក ដែលមានជំនាញខាងសុខភាពបុរស ការវះកាត់ដោយមនុស្សយន្ត (ប្រព័ន្ធដាវីនស៊ី) និងការព្យាបាលគ្រួសក្នុងតម្រងនោម។ លោកបានបញ្ចប់អាហារូបករណ៍អន្តរជាតិនៅមហាវិទ្យាល័យវេជ្ជសាស្ត្របៃឡ័រ (សហរដ្ឋអាមេរិក) មន្ទីរពេទ្យសាកលវិទ្យាល័យជូនថេនដូ (ជប៉ុន) និងមន្ទីរពេទ្យអនុស្សាវរីយ៍ឆាងហ្គុង (តៃវ៉ាន់)។ ខ្លឹមសារវេជ្ជសាស្ត្រទាំងអស់នៅលើគេហទំព័រនេះត្រូវបានសរសេរ និងពិនិត្យដោយលោកវេជ្ជបណ្ឌិត សូរ៉ាវី ដោយផ្អែកលើបទពិសោធន៍គ្លីនិក និងការបណ្តុះបណ្តាលអន្តរជាតិរបស់លោក។.