If your kidney, bladder or ureter stones are causing great pain or if they are too large and impacted to pass through your system, your doctor may recommend shockwave lithotripsy, a procedure which uses shock waves to break up stones (calculi) in the kidney, bladder, or ureter. Lithotripsy is a non-surgical procedure in which shockwaves are administered via a machine either outside the body (extracorporeally) or inside the body (intracorporeally.)

Extracorporeal Shockwave Lithotripsy (ESWL)

Lithotripsy is most commonly administered by lithotripter, a machine that generates and focuses high energy shock waves towards your stones. Since ESWL is sometimes painful, the procedure is often performed under general or localized anesthesia. Patients who are allergic or sensitive to anesthesia can undergo anesthesia-free ESWL.

After locating your stones via fluoroscopic x-ray imaging or ultrasound imaging, your doctor will direct the shockwaves through a water-filled cushion or coupling device placed under your back or on your abdomen, depending on the location of the stones. Older patients may feel more comfortable resting in a tub of water during the procedure. You may feel tapping or vibrations (like a rubber band) while shockwaves are delivered.

ESWL usually takes between 45-60 minutes, and can require up to two hours of recovery time. Most patients resume their normal daily activities within a day or two of the procedure.

Your doctor may prescribe an antibiotic to reduce your risk of infection, and OTC (over the counter) painkillers to reduce discomfort while you wait for the stones to pass. Stones generally pass within several weeks of the procedure, and you can expect to increase our fluid consumption to help the stones pass.

Intercorporeal Lithotripsy

Your doctor may recommend intercorporeal lithotripsy if ESWL is counter-indicated due to the size, location, or density of your stones.Intercorporeal lithotripsy is administered through the urethra via endoscope, a long, thin tube with a light and camera at the end. Several tools can be used through the endoscope to break up the stones: lasers, endoscopic ultrasound shockwaves (through small incisions in the abdomen), or with specialized “jackhammer-like” mechanical devices. Sometimes the stone fragments are gathered through tiny baskets, or sometimes they are left to pass through the urine naturally.

All medical procedures carry the risk of side effects. While lithotripsy is considered a safe procedure, some patients experience blood in the urine or swelling. If your stones are not sufficiently broken down, your doctor may recommend repeat lithotripsy.

Talk to your doctor about whether lithotripsy would help to eliminate your kidney, bladder, or ureter stones.