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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 Stone

Kidney Stones

Copyright © Nucleus Medical Media, Inc.

 

Reasons for Procedure    TOP

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    TOP

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    TOP

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    TOP

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?    TOP

45-60 minutes

How Much Will It Hurt?    TOP

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    TOP

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    TOP

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 March 8, 2018.

Lithotripsy. National Kidney Foundation website. Available at: https://www.kidney.org/atoz/content/lithotripsy. Accessed March 8, 2018.

Nephrolithiasis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114904/Nephrolithiasis . Updated February 5, 2018. Accessed March 8, 2018.



Last reviewed March 2018 by EBSCO Medical Review Board Adrienne Carmack, MD
Last Updated: 3/3/2014

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