ESWL (Extracorporeal Shock Wave Lithotripsy)

1. What is ESWL?

Extracorporeal Shock Wave Lithotripsy (ESWL) is a non-invasive procedure used to treat kidney stones. It uses high-energy shock waves to break stones into smaller fragments, allowing them to pass naturally through the urinary tract.

2. Who is a candidate for ESWL?

ESWL is most effective for:

  • Kidney or upper ureteral stones

  • Stones that are less than 2 cm in size

  • Patients with normal kidney function

  • Stones that are visible on X-ray

Your urologist will use imaging and urine/blood tests to determine if ESWL is right for you.

3. How does ESWL work?

  • You lie on a treatment table or in a water bath

  • Shock waves are focused on the kidney stone using ultrasound or X-ray guidance

  • The waves break the stone into sand-like particles

  • These fragments pass naturally in the urine over days or weeks

The procedure usually takes 30–60 minutes.

4. Is ESWL painful?

Most patients tolerate ESWL well. Depending on the stone's size and location:

  • You may receive light sedation, IV pain medication, or anesthesia

  • Some discomfort or cramping may occur as the stone passes

5. What is recovery like after ESWL?

  • Most people go home the same day

  • You may resume normal activities in 1–2 days

  • Drink plenty of fluids to help flush out stone fragments

  • You may see blood in your urine or feel mild flank discomfort for a few days

6. What are the risks or side effects of ESWL?

While ESWL is safe and widely used, possible side effects include:

  • Blood in the urine (hematuria)

  • Pain during stone passage

  • Bruising or mild back pain

  • Incomplete stone clearance

  • Rarely, blockage from stone fragments (steinstrasse) or infection

Your urologist will review how to manage these and reduce your risk.

7. How effective is ESWL?

Success depends on:

  • Stone size, type, and location

  • Patient anatomy and body weight

  • Hydration and post-procedure care

70–90% of small kidney stones are cleared with one ESWL session. Some patients may need a second treatment or alternative therapies.

8. What should I do after the procedure?

  • Stay hydrated to help pass fragments

  • Strain your urine to collect stone pieces for analysis

  • Take prescribed pain medication or antibiotics, if recommended

  • Follow up with imaging to confirm stone clearance

9. Are there alternatives to ESWL?

Yes, if ESWL is not suitable, other options may include:

  • Ureteroscopy (URS)

  • Percutaneous nephrolithotomy (PCNL)

  • Medical expulsion therapy for small stones

Your urologist will recommend the best treatment based on your individual case.