The injuries of extracorporeal shock wave lithotripsy (ESWL) include lithotripsy-related complications, infection-related complications and complications caused by shock wave damage to related tissues.
1. Lithotripsy-related complications: mainly include stone street, re-growth of residual stone and renal colic. The key to preventing lithotripsy is to strictly control the indications. For postoperative residual stone, it is recommended to perform imaging examination 4 weeks after ESWL to determine the residual stone condition; for symptomatic patients, obstruction should be relieved and symptoms eliminated actively.
2. Infection-related complications: mainly include urinary tract infection, sepsis, infectious shock and so on. Reasonable use of antibacterial drugs is an effective means of treating urinary tract infection after ESWL; when combined with obstruction, active drainage should be provided. When infectious shock occurs, it should be handled immediately according to the principles of infectious shock management, and at the same time, effective urinary drainage should be performed, double J tube or percutaneous nephrolithotomy should be placed.
3. Shockwave injury-related tissue-related complications: including renal injury, cardiovascular adverse events, digestive system injury. Most patients with subperitoneal and perirenal hematomas can be treated nonsurgically. Selective arterial embolization or surgical treatment may be considered in cases of severe renal laceration with subperineal hematoma when nonoperative treatment is not effective.
If there are urinary stones, it is recommended to consult a regular hospital and choose extracorporeal shock wave lithotripsy with specific conditions.