Extracorporeal Shock Wave Lithotripsy

ESWL

Definition

Extracorporeal shock wave lithotripsy is a nonsurgical treatment for kidney stones. It uses high-energy shock waves to break the stones into tiny pieces. The pieces can then be passed with urine.

Kidney Stones

Reasons for Procedure

Lithotripsy is used to remove kidney stones that:

Are too large to pass
Cause constant pain
Block the flow of urine
Cause an ongoing infection
Damage kidney tissue
Cause bleeding

Most people who have lithotripsy for kidney stones are free of stones within 3 months of treatment. Those with stones in the kidney and upper ureter have the most success with treatment. There may be fragments that are too large to pass after the procedure. They can be treated with lithotripsy again.

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

Blood in the urine
Bruising in the back or abdomen
Pain as the stone fragments pass
Failure of stone fragments to pass, requiring additional surgery
Need for additional treatments
Reaction to anesthesia

Some factors that may increase the risk of complications include:

Bleeding disorders or taking medications that reduce blood clotting
Obesity
Skeletal deformities

What to Expect

Prior to Procedure

Your doctor may do the following:

Physical exam
Blood and urine tests
Imaging studies to help locate the stones

Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure.

Anesthesia

Heavy sedation or general anesthesia is usually used. Heavy sedation will keep you calm. With general anesthesia, you will be asleep through the procedure.

Description of the Procedure

You will be placed on a soft cushion on top of a table. Shock waves can be passed to the stones through this cushion.

X-rays or ultrasound will be used to locate the stone. Your body will be positioned to target the stone. Shock waves will be passed through the stones until they are crushed. They will be crushed into pieces as small as grains of sand.

How Long Will It Take?

45-60 minutes

How Much Will It Hurt?

Anesthesia prevents pain during the procedure. There may be some pain and discomfort afterward from the passage of broken stones. There may also be some bruising on the area treated. Pain and discomfort after the procedure can be managed with medication.

Postoperative Care

You will be able to move almost immediately after the procedure. Drink plenty of water in the weeks after the procedure to help the stone pieces pass.

Call Your Doctor

After arriving home, contact your doctor if any of the following occur:

Extreme urge or inability to urinate
Excessive blood in your urine
Signs of infection, including fever and chills
Nausea and/or vomiting that you cannot control with the medications you've been given
Pain that you cannot control with the medications you've been given
Cough, shortness of breath, or chest pain

If you think you have an emergency, call for medical help right away.

RESOURCES

National Kidney Foundation
http://www.kidney.org

National Kidney and Urologic Diseases Information Clearinghouse
http://kidney.niddk.nih.gov

CANADIAN RESOURCES

Canadian Urological Association
http://www.cua.org

The Kidney Foundation of Canada
http://www.kidney.ca

References

Kidney stones in adults. National Kidney and Urologic Diseases Information Clearinghouse website. Available at: http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/kidney-stones-in-adults/Pages/facts.aspx. Updated February 2013. Accessed March 7, 2016.

Lithotripsy. National Kidney Foundation website. Available at: https://www.kidney.org/atoz/content/lithotripsy. Accessed March 7, 2016.

Nephrolithiasis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 24, 2016. Accessed March 7, 2016.

Revision Information

Reviewer: Adrienne Carmack, MD
Review Date: 03/2016
Update Date: 03/03/2014

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.