Can i have eswl done on a 4mm kidney stone?

If seen : Usually a 4 mm stone will pass but there are occasions that it will not and needs intervention . If seen on fluroscopy with eswal machine then it can be treated but many times you cannot see it.

ESWL: While 4mm is an acceptable size stone for eswl, it may be difficult to see and target on fluoroscopy. Uric acid stones of this size generally cannot be seen at all on fluoroscopy. As uric acid stones grow they sometimes become partially calcified and can be seen on standard x-ray.

May be: Are you a recurrent stone former? If yes, what is the size of stone you have ever passed? Largely, a 4-mm stone takes 2 wks to travel through ureter in 75-85% of cases. As to using eswl, this size may be hard to see for eswl if it's not dense, body is thick, ; feces in bowel is obvious, it would be hard to localize stone for eswl. In fact, nowadays, most of.

Yes, it can be done: The first question you must answer for yourself is do you want to treat the stone or observe it and if observing and the stone is obstructive, your chances of passing it will be approx 90% (with Flomax). If you want treatment, then yes, a 4mm stone is amenable to eswl. Preferably, it should be seen on an xray but there are ways it can be done even if not seen on xray with certain eswl machines