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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 to enable easy passage of the fragments out of the body within the urine. ESWL is indicated in people with large kidney stones causing pain, urinary tract infection, bleeding, and renal damage.

Prior to the procedure a mild sedative and pain medications are given. General anaesthesia is often used to keep you asleep and free of pain during the procedure. To prevent infection, your doctor will also prescribe you antibiotics.

ESWL takes about 45 to 60 minutes to complete. During the procedure 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.

After the procedure

You will be taken to the recovery room to be monitored for a couple hours after your procedure. ESWL 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 also be instructed to drink plenty of water to help clear the stone fragments out of your urinary system.

Risks and Complications

ESWL is considered to be a relatively safe procedure but as with any medical procedure there are risks involved. Some risks associated with ESWL include:

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