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Kidney Stone: Shock Wave Treatment (Lithotripsy)


 What is shock wave treatment for kidney stones?
 When is it used?
 How do I prepare for this procedure?
 What happens during the procedure?
 What happens after the procedure?
 What are the risks of this procedure?

Kidney: Illustration
Kidney: IllustrationClick here to view a full size picture.

What is shock wave treatment for kidney stones?

Shock waves from a lithotripsy machine are a way to break up kidney stones into smaller pieces. The pieces of stone are then flushed out of the body in the urine.

A kidney stone is a solid piece of material that forms in your urinary system. The stones are formed from substances in the urine. You can get a stone in any part of the urinary tract, including the kidneys, ureters, bladder, and urethra. Stones may be small or large. You may have just 1 stone or many stones.

The kidneys are inside your belly, on either side of your spine just above your waist. They make urine by taking waste products and extra salt and water from the blood. The ureters are tubes that carry urine from the kidneys to the bladder. The bladder holds your urine until you urinate, and the urethra is the tube that drains urine from the bladder.

The full name for this procedure is extracorporeal shock wave lithotripsy, or ESWL.

When is it used?

ESWL may be done when stones in the kidney are painful, damaging the kidney, or blocking the flow of urine to the bladder.

The treatment of kidney stones depends on how big the stones are, where they are, and what they are made of. Many kidney stones pass out of the body without treatment. Some stones that do not pass on their own can be treated with lithotripsy.

Instead of this procedure, other treatments may include:

Your healthcare provider may recommend a different type of treatment if:

You may choose not to have treatment. Ask your healthcare provider about your choices for treatment and the risks.

How do I prepare for this procedure?

What happens during the procedure?

This procedure is usually done in a surgical center or at the hospital.

Usually you will be given general anesthesia to keep you from feeling pain. General anesthesia relaxes your muscles and you will be asleep.

Your provider may put a tube called a stent into your ureter before the procedure to help the pieces of stone pass. The ureter is a tube that carries urine from the kidney to the bladder.

You will lie on a table over the lithotripsy machine. The lithotripsy machine will send shock waves against the kidney stones to break them. Your healthcare provider will use X-rays to find the kidney stones, keep the shock waves focused on them, and track their breakdown. The stones can then pass out of your body after a few days.

This procedure usually takes about 1 hour.

What happens after the procedure?

After the procedure you may stay in a recovery area for a few hours and then go home.

You may have pain after the procedure as the pieces of stone pass out of the ureter into the bladder. You may be given medicine for this pain after the procedure. Drink a lot of fluids to help keep stones from reforming and to flush out the remaining pieces of stone. Follow your provider's instructions for straining your urine to collect all stone fragments.

If you had a stent put in your ureter, your provider may take it out in 3 to 10 days. During that time you may need to go to the bathroom more often than usual. It is very common, especially if a stent is used, to have blood in your urine. This may last for several days after the procedure.

For a few days you may have bruising and minor discomfort in the back or abdomen from the shock waves.

You may be given medicine to keep from getting more stones.

Follow your healthcare provider's instructions. Ask your provider:

Make sure you know when you should come back for a checkup.

What are the risks of this procedure?

Your healthcare provider will explain the procedure and any risks. Some possible risks include:

There is risk with every treatment or procedure. Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.

healthinformatics info

Reference Sources:

Assimos D. Re: Extracorporeal Shock Wave Lithotripsy (ESWL) versus ureteroscopic management for ureteric calculi. J Urol. 2012 Jul;188(1):159.

Chew BH, Zavaglia B, Sutton C, Masson RK, Chan SH, Hamidizadeh R, Lee JK, Arsovska O, Rowley VA, Zwirewich C, Afshar K, Paterson RF. Twenty-year prevalence of diabetes mellitus and hypertension in patients receiving shock-wave lithotripsy for urolithiasis. BJU Int. 2011 Jun 2. doi: 10.1111/j.1464-410X.2011.10291.

Deem S, Defade B, Modak A, Emmett M, Martinez F, Davalos J. Percutaneous Nephrolithotomy Versus Extracorporeal Shock Wave Lithotripsy for Moderate Sized Kidney Stones. Urology. 2011 Jun 9.

Micali S, Sighinolfi MC, Grande M, Rivalta M, De Stefani S, Bianchi G: Dornier Lithotripter S 220 F EMSE: the first report of over 1000 treatments. Urology. 2009 Dec;74(6):1211-4.

Polat F, et al. Safety of ESWL in elderly: evaluation of independent predictors and comorbidity on stone-free rate and complications. Geriatr Gerontol Int. 2012 Jul;12(3):413-7.

Porfyris O, and D. Delakas. Post-extracorporeal shockwave lithotripsy residual stone fragments: clinical significance and management. Scand J Urol Nephrol. 2012 Jun;46(3):188-95.

Rassweiler JJ, et al. Shock wave technology and application: an update. Eur Urol. 2011 May;59(5):784-96.

Wiesenthal JD, Ghiculete D, Ray AA, Honey RJ, Pace KT. A clinical nomogram to predict the successful shock wave lithotripsy of renal and ureteral calculi. J Urol. 2011 Aug;186(2):556-62.

Zaytoun OM, Yakoubi R, Zahran AR, Fouda K, Marzouk E, Gaafar S, Fareed K. Tamsulosin and doxazosin as adjunctive therapy following shock-wave lithotripsy of renal calculi: randomized controlled trial. Urol Res. 2011 Aug 12.


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Last Modified: 2013-04-03

Last Reviewed: 2012-10-08

Website Updated: March 2014

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This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.


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