Shockwave Lithotripsy (ESWL)
The Key Things to Know:
Shockwave Lithotripsy (ESWL) is a non-invasive treatment that uses focused sound waves to break kidney or ureteric stones into smaller fragments so they can pass naturally in the urine. It is effective for many stones up to about 1cm in size and avoids the need for surgery.
What It Is
ESWL is performed using a machine that generates shockwaves, focused precisely on the stone using X-ray or ultrasound guidance. The waves travel harmlessly through the skin and body tissues until they reach the stone, breaking it into smaller pieces. The treatment usually takes 30-45 minutes and is performed as an outpatient or day procedure under light sedation or analgesia.
When It's Needed
ESWL is recommended when:
Stones are less than 1 cm in size and visible on X-ray
Stones are located in the kidney or upper ureter
There is no active infection or severe obstruction
The patient prefers a non-surgical option
Surgery Diagram
Benefits
Non-invasive - no incision or scope
Day procedure with minimal recovery time
High success rate for suitable stones (≈70-85%)
Repeatable if needed
Risks
Mild back or flank discomfort during treatment
Blood in urine for a few days (common)
Stone fragments may cause temporary pain or obstruction (≈10-15%)
Infection or fever (≈5%)
Bruising of the skin or kidney (rare)
Occasionally, multiple sessions are needed for complete clearance
What to Expect After Surgery
You can go home shortly after ESWL. Drink plenty of fluids to help flush out fragments. Some discomfort or blood in the urine is normal for a few days. Pain from passing stone fragments may occur as they move down the ureter. Follow-up imaging is arranged to confirm clearance, usually within 4-6 weeks.
FAQs
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Best results occur for stones less than 1 cm and located in the kidney or upper ureter. Hard or large stones may need other treatments.
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Fragments usually pass over several days to weeks after treatment.
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Yes, about 15-25% of patients require a repeat ESWL session for complete clearance.
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