Treatment Options: Non-Invasive

Extracorporeal Shock Wave Lithotripsy (ESWL) uses external shock waves to break a stone into small pieces that they can more easily travel through the urinary tract and pass from the body.

• You lie on a water-filled cushion, and the surgeon uses X-rays or ultrasound tests to precisely locate the stone. High-energy sound waves pass through your body to break the stone into small pieces. These small pieces move through the urinary tract and out of the body more easily than a large stone
• The procedure may take about an hour
• You may receive sedatives and/or local anesthesia
• Your surgeon may use a catheter when your stones are larger than 2.5 cm. A catheter is a small, short tube of flexible plastic mesh that holds the ureter open. This helps the small stone pieces to pass without blocking the ureter
• You may need multiple ESWL sessions

Benefit and Risks

After ESWL, stone fragments usually pass in the urine for a few days and cause mild pain. If you have a larger stone, you may need more ESWL or other treatments. ESWL can be an effective non-invasive treatment for smaller stones. ESWL machines can be low- or high-energy. Low-energy machines cause less discomfort, but you may need more treatments before the stone is broken into pieces small enough to pass.

ESWL does not replace the need for the preventive treatment of kidney stones, such as drinking a lot of fluids.

Complications of ESWL include:

• Pain caused by the passage of stone fragments.
• Blocked urine flow as a result of stone fragments becoming stuck in the urinary tract. The fragments may then need to be removed with a ureteroscope.
• Urinary tract infection.
• Bleeding around the outside of the kidney.
• Damage to the kidney tissue or nearby structures in the stomach area may occur from ESWL. Some patients are at greater risk than others.

After Care

ESWL is usually an outpatient procedure. You go home after the treatment and do not have to spend a night in the hospital. Your doctor will recommend resting for one to two days following your treatment before returning to normal activities.

It may take a few days or weeks for all the stone fragments to pass from your body. You may have mild pain as the small fragments pass through the urinary tract.

Remember to drink plenty of water in the weeks after treatment (8-10 glasses a day), water will help pass any remaining pieces of stone and prevent them from coming back. You may have pain and nausea when/if any remaining pieces pass. You may experience the pain and nausea immediately after treatment and which may last for up to 4-8 weeks. Follow your doctors instructions for taking pain medication and drinking lots of water to help relieve these symptoms. It is normal to have a small amount of blood in your urine for a few days to weeks after the procedure.

You will be asked to visit your doctor for a follow-up appointment in the weeks following the lithotripsy. (For example, this might include a kidney X-ray to determine if kidney stones are still present.)

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