Lithotripsy

Also known as: Extracorporeal shock wave lithotripsy, ESWL

Kidney stones are a painful medical problem that affects more than 400,000 Americans every year. The stones are formed from hardened mineral deposits within the kidney and urinary tracts. If the stones remain tiny enough, they will often pass through the urinary tract and out of the body in the urine without being noticed. There are also medications that decrease stone formation or help break down and remove the material that is causing the stone.

If the stone is too large to pass on its own it can block urine flow and can cause irreversible kidney damage or infection and may require surgical or non-surgical treatment. One of the best ways to treat kidney stones without surgery is called extracorporeal shock wave lithotripsy (ESWL), commonly known as lithotripsy.

The Procedure
The patient will wear a medical gown and lie on an exam table on top of a soft, water-filled cushion. A general anesthetic is given to help him remain still during the procedure and to reduce any discomfort. The physician pinpoints the location of the stone(s) by using X-rays or ultrasound. When the stone is located, the lithotripsy unit sends high-energy shock (sound) waves through the water and through the body to crush the stones into pieces. The procedure takes 30 to 60 minutes.

After the Procedure
When the patient recovers from the anesthetic, he may feel some discomfort in his lower back. The stone, which was crushed during the lithotripsy treatment, will usually pass from the patient's body in urine. Some patients notice small amounts of blood in their urine. Many patients go home the same day they've had treatment.

Risks of lithotripsy include:

  • Pain from passing stone fragments. This is the most common side effect
  • Blocked urine flow if stone fragments get stuck in the urinary tract. The fragments may then need to be removed with a ureteroscope
  • Urinary tract infection
  • Bleeding around the outside of the kidney

Your doctor may recommend this lithotripsy if:

  • The stone is not passing on its own and is causing pain that will not go away
  • The stone is completely blocking the urine flow
  • You have only one working kidney, and your doctor worries that the stone is affecting how well the kidney works
  • The stone is causing serious bleeding
  • The stone keeps growing
  • You have had a kidney transplant, and your doctor worries about damage from a stone
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