Extracorporeal shockwave lithotripsy is a non-surgical procedure which uses shock waves to break down large or impacted calculi (stones sometimes found in the kidney, ureter, or bladder) into fragments so they can be removed from the body.

While ESWL can be performed under general anesthesia or with localized anesthesia, it is possible to perform anesthesia-free ESWL. People who are allergic to common painkillers may find anesthesia-free ESWL advantageous.

Advantages of Anesthesia-Free Shock Wave Lithotripsy

There are significant advantages to performing anesthesia free shock wave lithotripsy:

• Shock wave lithotripsy performed without anesthesia can be done in an outpatient clinic.
• Avoiding anesthesia is less expensive than it analgesic counterpart.
• Less analgesic means avoiding side effects from general anesthesia, injectable painkillers, and opioids which are often used as painkillers during surgical procedures.

How is ESWL Performed?

ESWL without anesthesia can be performed in an outpatient clinic in about an hour. You can spend up to two hours recovering at the clinic, but you should be able to go home the same day as the procedure. The shock waves may feel like tapping or like a vibrating rubber band, and you may feel some pain or discomfort as the stones are broken down.

ESWL is performed using a lithotripter machine which emits high-energy shock waves directed towards a target, as follows:

• Before the surgery your doctor will likely prescribe an antibiotic prophylactically (to prevent an infection from developing.)
• Your doctor will have you lie down and place a water-filled cushion or a “coupling” device under your back or on your abdomen. Some patients find that they are more comfortable receiving ESWL in a tub of water.
• After your doctor uses fluoroscopic x-rays or ultrasound to locate your stones, he will direct shockwaves through the lithotripter to break down your stones.

Your doctor may prescribe over-the-counter pain medications (OTC) while you wait for the stones to pass. You can expect to resume your normal daily activities within 2 days of the surgery.

ESWL is considered a relatively safe procedure, but complications such as blood in urine, swelling, infection, or (in extreme cases) kidney blockages or failure could result. ESWL without anesthesia is not recommended for children, individuals with severe anxiety, in very thin or very obese patients, or when a lengthy procedure is expected.

Talk to your doctor to see if anesthesia-free ESWL is right for you.