Managing Kidney Stones: Post-Extracorporeal Shock Wave Treatment Concerns

Q: Managing Kidney Stones: Post-Extracorporeal Shock Wave Treatment Concerns

Hello： Currently, extracorporeal shock wave lithotripsy is the mainstream treatment for kidney stones. <br>After the stones are fragmented, hematuria may occur, and experiencing lower back discomfort and pain is also normal. <br>Therefore, it is important to drink plenty of water

After extracorporeal shock wave lithotripsy (ESWL)

Hello, Doctor.
I would like to ask a few questions.
On April 28th, I went to the urology department due to back pain and hematuria, and I was diagnosed with a kidney stone, which was noted to be less than 1 cm in size.
That evening, the issue was addressed.
However, a week later, I noticed that I still had hematuria.
I felt some discomfort in the kidney area, but it was not as painful as before.
During a follow-up visit, an X-ray revealed another stone, and I am unsure if it is the same one that was not completely treated or a new one.
This stone is also less than 1 cm in size.
The doctor mentioned that due to health insurance regulations, extracorporeal shock wave lithotripsy needs to be spaced one month apart, so it has been scheduled for the end of May.

However, I am quite concerned because I still have mild hematuria and occasionally see small blood clots.
The discomfort in my back is not severe, but I feel a bit uneasy.
Am I expected to endure this hematuria and discomfort for an entire month without doing anything? What should I do if the pain becomes severe before my next appointment? My doctor has prescribed medication for pain, which I can take when needed, and I have been drinking plenty of water.

Additionally, I would like to ask if it is safe for me to exercise in my current condition.
Given my history of kidney stones, which my father also has, is it advisable for me to avoid tea, such as green tea or black tea? Thank you very much, Doctor, for taking the time to respond.

A Kuan, 20~29 year old female. Ask Date: 2019/05/09

Dr. Du Shixi reply Urology

Hello: Currently, extracorporeal shock wave lithotripsy is the mainstream treatment for kidney stones.
After the stones are fragmented, hematuria may occur, and experiencing lower back discomfort and pain is also normal.
Therefore, it is important to drink plenty of water to increase urine output and help expel the fragments.
Generally, a urine output of 1500-2000 cc is recommended.
If the hematuria is mild and there is no pain during urination, exercise is permissible and can aid in expulsion.
However, if the hematuria is severe and there is significant pain in the lower back, it is advisable to rest more.
If the pain is intense, medication should be taken for pain control (this applies to all cases of stone fragmentation).
It is best to drink plain water; consumption of tea, coffee, and artificially flavored beverages should be limited, as they can contribute to stone formation.
Wishing you good health.

Reply Date: 2019/05/09

More Info

Managing kidney stones can be a complex process, especially when dealing with post-treatment concerns like those following extracorporeal shock wave lithotripsy (ESWL). Your situation, involving persistent hematuria (blood in urine) and discomfort after treatment, raises several important points that need to be addressed.

Firstly, it's not uncommon for patients to experience some degree of hematuria following ESWL. This can occur due to the fragmentation of the stones, which may irritate the urinary tract. The presence of small blood clots can also be a result of this irritation. However, if the bleeding persists or worsens, it is crucial to follow up with your healthcare provider to rule out any complications, such as infection or additional stone formation.

Regarding your discomfort and the potential for pain, it is essential to monitor your symptoms closely. If you experience significant pain that is not manageable with the prescribed medications, or if you develop new symptoms such as fever or chills, you should seek medical attention promptly. Pain management is a critical aspect of your care, and your doctor can adjust your medications or recommend additional interventions if necessary.

As for physical activity, it is generally advisable to avoid strenuous exercise immediately following ESWL, especially if you are experiencing discomfort. Light activities, such as walking, may be acceptable, but you should listen to your body and avoid anything that exacerbates your symptoms. Always consult your physician before resuming any exercise regimen, as they can provide personalized recommendations based on your current condition.

In terms of dietary considerations, certain beverages can influence kidney stone formation, particularly in individuals with a history of stones. Tea, including green and black varieties, contains oxalates, which can contribute to the formation of calcium oxalate stones. If you have a family history of kidney stones, it may be prudent to limit your intake of high-oxalate foods and beverages, including tea. Instead, focus on hydration with water, which is the best choice for preventing stone formation. Your doctor or a registered dietitian can provide specific dietary guidelines tailored to your needs.

Finally, regarding the timeline for your next ESWL session, it is essential to adhere to your physician's recommendations. The one-month waiting period is standard practice to allow your body to heal and to assess the effectiveness of the initial treatment. If you have concerns about your symptoms during this waiting period, do not hesitate to reach out to your healthcare provider for guidance.

In summary, managing kidney stones involves a multifaceted approach that includes monitoring symptoms, adhering to treatment plans, and making informed dietary choices. Open communication with your healthcare provider is vital to ensure that any complications are addressed promptly and that you receive the best possible care tailored to your individual circumstances.

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