POST ESWL/STENT
PLACEMENT SURGERY INSTRUCTION SHEET
DEFINITIONS:
ESWL stands for
Extracorporeal Shock Wave Lithotripsy.
Water waves are used to fracture stones in the urinary tract.
A ureteral stent is a hollow plastic tube that runs between the
kidney and bladder. It prevents
stone fragments from blocking the ureter.
Not all patients who undergo ESWL will have a stent placed.
The decision to place a stent is determined by your urologist at the
time of surgery.
GENERAL INSTRUCTIONS:
Despite the fact
that no skin incisions were used, the flank area may be bruised and tender
from the water waves hitting the skin and deeper tissues. The stent is a
foreign body which will irritate the bladder wall. This irritation is
manifested by increased frequency of
urination, both day and night, and also an increase in the urge to
urinate. In some, the urge to urinate is
present almost always. Sometimes the urge is strong enough that
you may not be able to stop yourself
from urinating. The only real cure is to remove the stent and then give time
for the bladder wall to heal which can't be done until the danger of the
ureter swelling shut has passed. (Varies from 3-21 days).
You may see some
blood in your urine after the procedure. Do not be alarmed, even if the
urine was clear for a while. Get off your feet and drink lots of fluids
until clearing occurs. If you start
to pass clots or don't improve, call us.
DIET:
You may return to
your normal diet immediately. Because of the bladder irritability, alcohol,
spicy foods, acidy
foods and drinks with
caffeine may cause irritation or frequency and should be used in moderation.
To keep your urine flowing freely and to avoid constipation, drink plenty of
fluids during the day (8 - 10
glasses). Tip: Avoid Cranberry Juice -- very acidy!!
ACTIVITY:
Your physical
activity doesn't need to be restricted. However, if you are very active, you
may see some
blood in the urine. We would suggest to cut down your activity under these
circumstances until the bleeding has
stopped.
BOWELS:
It is important to
keep your bowels regular during the postoperative period. Straining with
bowel
movements can cause bleeding. A bowel movement every other day is
reasonable. Use a mild laxative if
needed, such as Milk
of Magnesia 2-3 Tablespoons, or 2 Dulcolax tablets. Call if you continue to
have problems. If you had been taking narcotics for pain, before, during or
after your surgery, you may be
constipated. Take a laxative if necessary.
MEDICATION:
You should resume
your pre-surgery medications unless told not to. In addition you will often
be given an
antibiotic to prevent infection. These should be taken as prescribed until
the bottles are finished unless you
are having an unusual reaction to one of the drugs.
PROBLEMS YOU SHOULD
REPORT TO US:
a.
Fevers over 100.5
Fahrenheit.
b.
Heavy bleeding, or clots (See
notes above about blood in urine).
c.
Inability to
urinate.
d.
Drug reactions (Hives,
rash, nausea, vomiting, diarrhea).
e. Severe burning or pain
with urination that is not improving.
FOLLOW-UP:
You will need a
follow-up appointment to monitor your progress. Call for this appointment at the
number above when you get home or from
the phone in your hospital room before leaving. Usually the
first appointment will be about 3 - 14 days
after your surgery any your stent (if placed) will probably be removed at
this time.