Extracorporeal Shock Wave Lithotripsy

Why is it done?

Kidney stones, or renal calculi, are solid masses made up of tiny crystals. They can form when urine contains too much of a certain substance such as calcium, cystine, struvite or uric acid. Stones that form in the kidneys can either continue to grow, or pass into the ureters, which are the tubes that empties into the bladder. If the stones are too large, they can block the flow of urine from the kidneys causing severe pain and discomfort. Once a physician determines that a kidney stone can not pass through on its own, they look at the option of surgery. Extracorporeal shock wave lithotripsy, or ESWL, is the least invasive choice. Other options include Percutaneous nephrolithotomy, Ureteroscopy, or standard open surgery (nephrolithotomy).


Who should be treated with ESWL?

 ESWL is done for patients that have kidney stones up to 2cm in diameter.  It may work best for kidney stones located in the kidney rather then the ureter, although it is possible.


How is ESWL done?

ESWL is done on an outpatient basis at either a hospital or surgery center. Your surgeon may administer a sedative or local anesthetic. You will be placed on a table with a water filled cushion or sunken area where your kidneys are. A ultrasound or x-ray is used to determine the exact location of the stone and then high-energy sound waves pass through your body without injuring it and break the stone into small pieces. These small pieces will then be able to pass through the urinary tract and out of the body. The whole process generally takes about an hour and there is little to no recovery.


What is the outcome?

After ESWL, it may take a few days to several weeks to pass all the fragments and your surgeon may ask you to strain your urine to collect any of the pieces to analyze.

For most patients who have kidney stones smaller than 10mm-either in the kidney or in the ureter-ESWL gets rid of all of the stone or leaves only small fragments that don't cause any symptoms. To help facilitate this process and minimize discomfort, a ureteral stent is sometimes put into place to allow for easier transit and passage through the ureter. If you had a larger stone, you may need repeat treatments.

You urologist will schedule a follow up x-ray several weeks after the procedure to determine if the stone broke up into small pieces, and if those small pieces passed out of the kidney.

Video of ESWL procedure

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Comments 2 comments

Wealthmadehealthy profile image

Wealthmadehealthy 6 years ago from Somewhere in the Lone Star State

Very Imformative

L.L. Woodard profile image

L.L. Woodard 6 years ago from Oklahoma City

Great information and easy-to-understand explanations.

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