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How the 4th Generation ESWL works?

4th Gen ESWL
FB Dr Soarawee
Soarawee Weerasopone, MD

Minimally Invasive Uro-Oncologist
Royal Phnom Penh hospital, Kingdom of Cambodia

Regarding to a ton of questions on Extracorporeal Shockwave Lithotripsy (ESWL), a minimal invasive procedure for kidney stones so I will launch this topic especially for the 4th Generation one which currently implicated at Royal Phnom Penh hospital, Cambodia.

How the 4th Generation ESWL works?
4th Generation Extracorporeal Shockwave Lithotripsy is currently function at Royal Phnom Penh hospital, Cambodia.

How ESWL works?

  • I must say that the this technology is an incidental breakthrough during World War 2 which develops generation by generation. Latest advance generation will give us the more benefit in term of the perioperative pain and complications reduction. 4th Generation machine is the latest ever technology so far (2021)
  • It will create shockwave pulse from its shockwave head which implicated at the patient’s skin around the flank area (Flank area is where our kidney lies)
  • The shockwave will travel through the patient’s skin and turn kidney stones into pieces.
  • The ESWL only-ability is done but enough. Then the natural urine which continuous producing from our kidney will flush the kidney stone fragments down and turns out as a normal urination.
EAU ESWL
Auto-tracking system is the strong point of this latest Generation ESWL application.

What are the strong pros of 4th Generation ESWL over the previous version one?

  • 4th Generation machine is equipped with auto-tracking system. Please imagine my voice on it; it’s like a targeting missile machine in warfare, so the shockwave will accurately hit the kidney stone with no missing target and resulting in less pain from unnecessary kidney tissue hit by shockwave pulse.
  • Minimized perioperative pain make 4th Generation procedure can be managed as day-care procedure with free from anesthesia team.
    • Less medical expense on anesthesia team
    • Less medical expense on hospitalization from anesthetic postoperative effect
    • Less hospitalize time consumption, only 3 hours of procedure
    • Less complications were reported due to shockwave accurately hit the stone, 98.5% hit rate over 82.6% hit rate from 3rd old Generation one
Good outcome
We have over than 3 years of experiences in this machine and has our own data.

How much success rate of 4th Generation ESWL session we can guarantee?

  • Due to ESWL is the minimally invasive kidney stone procedure so it is perfectly matching with small kidney stone.
  • European Association of Urology 2020 has recommended ESWL in kidney stone less than 2 cm.
  • Over 3 years of the real practicing, Royal Phnom Penh has our individual data on the 4th Generation ESWL.
    • 84% success rate on < 1 cm kidney stone
    • 77% success rate on 1 – 2 cm kidney stone
    • 60% success rate on > 2 cm kidney stone
    • ***The success rate defines as less than 4 mm of kidney stone fragment found during the following up period
  • Post-ESWL patient instructions is provided here.
  • The history of all 4 generation ESWL is provided here.

Any questions on ESWL procedure, you can discuss with your trusted Urologist or that would be honored if you text me. See you in next topic!

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