Definition

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

Kidney Stone
Kidney Stones

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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 possible 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

The doctor will use previous tests to plan treatment. The care team will review your medicine before treatment. Some medicine may need to be stopped up to 1 week before the procedure.

Anesthesia

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

Description of the Procedure

The technician will ask you to lie on top of a table. The table can slide back and forth, up and down or side to side to get you in the right position. There will be a device over the bed that shows the doctor where the stone is. The doctor will use the images to align the shockwave device to the stone. This device is under the bed. When it is in the right position it will send a shockwave that is targeted to the stone. They will be crushed into pieces as small as grains of sand.

How Long Will It Take?

45 to 60 minutes

How Much Will It Hurt?

Anesthesia prevents pain during the procedure. There may be some soreness or bruising over the area after the surgery. Home care and medicine can ease discomfort. There may be some pain and discomfort as the broken stones pass.

Postoperative Care

You will be able to move almost immediately after the procedure.

Call Your Doctor

Call your doctor if any of these occur:

  • Extreme urge or inability to urinate
  • Excessive blood in your urine
  • Signs of infection, including fever and chills
  • Persistent nausea or vomiting
  • Pain that you cannot control with the medications you were given
  • Cough, shortness of breath, or chest pain

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

RESOURCES:

National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov

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

CANADIAN RESOURCES:

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

Kidney Foundation of Canada
https://www.kidney.ca

REFERENCES:

Kidney stones. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/urologic-diseases/kidney-stones. Accessed January 29, 2021.

Lithotripsy. National Kidney Foundation website. Available at: https://www.kidney.org/atoz/content/lithotripsy. Accessed January 29, 2021.

Nephrolithiasis. EBSCO DynaMed website. Available at: http://www.dynamed.com/topics/dmp~AN~T114904/Nephrolithiasis. Accessed January 29, 2021.

Last reviewed March 2021 by EBSCO Medical Review Board Adrienne Carmack, MD  Last Updated: 1/29/2021