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Extracorporeal Shock Wave Lithotripsy

What is Extracorporeal Shock Wave Lithotripsy?

Kidney stones are small, hard deposits that can develop in the kidneys. Lithotripsy, often referred to as extracorporeal shock wave lithotripsy (ESWL), is the most common procedure for the management of kidney stones (renal lithiasis). It uses shock waves to break up stones that form in the kidney, bladder or ureter, enabling easy passage of the fragments out of the body within the urine.

Indications for ESWL

Most kidney stones are small and can be passed in urine. However larger stones are unable to pass through the ureters and can cause bleeding, kidney damage or urinary tract infections and may require more invasive treatment.

Lithotripsy is indicated in people with large kidney stones causing pain, urinary tract infection, bleeding and renal damage.

Procedure for ESWL

Your doctor usually arrives at a diagnosis of kidney stones based on your symptoms and medical history. Blood tests, urine tests and other investigations may be ordered to confirm the diagnosis. Several diagnostic techniques such as X-ray, ultrasound, CT and intravenous urogram (contrast dye injected into the kidneys is detected through X-ray) may also be used to identify the location of the kidney stones.

During lithotripsy, you will lie on a water-filled cushion. High-energy sound waves that are created outside of the body travel through the body until they hit the kidney stones and break them into tiny pieces. You may feel a tapping sensation on your skin as the shockwaves enter the body.

A tube is inserted through your bladder or your back into your kidney to help drain urine from your kidneys until all the tiny fragments of stone pass out of your body. The tube may be inserted before or after the procedure. The procedure takes about 45 to 60 minutes to complete.

Recovery from ESWL

You will be taken to the recovery room to be monitored for a couple hours after the procedure. Lithotripsy is usually an outpatient procedure where you are able to go home on the same day. You can usually resume regular activities within a day or two. You may experience pain when the stone fragments pass, which occurs soon after treatment and may last for 4 to 8 weeks. Oral pain medications are prescribed to relieve pain. You will be instructed to drink plenty of water to help clear the stone fragments out of your urinary system.

Risks and complications associated with ESWL

Lithotripsy is considered a relatively safe procedure, but as with any medical procedure, there may be risks involved. Some risks associated with lithotripsy include:

  • Bleeding in or around the kidney
  • Kidney infection
  • Failure to remove the stones requiring additional treatment
  • Pain if a stone fragment blocks the flow of urine
  • Kidney damage or a decrease in kidney function
  • Ulcers in your stomach or intestine