Extracorporeal shockwave lithotripsy uses focused sound waves to breakup your stones from outside your body. The advantage of this treatment approach is that instruments may not need to be introduced into your body (unless your stone is large, in which case a stent is usually placed at the time of surgery).
ESWL may be associated with less discomfort than other treatment options such as ureteroscopy or percutaneous nephrolithotripsy. However, ESWL does not usually have as high of a success rate as these other surgical treatment options and is more likely to require re-treatments. For more information on comparing the surgical options for kidney stones, see our comparison chart.
ESWL is easier to perform for stones that are visible on plain x-rays because this type of x-ray is used to target the stones during treatment. For stones that are not visible on plain x-ray, such as uric acid stones, special techniques can be used to allow ESWL to still be used. Stones that are less dense (which can be measured from CT scans) tend to respond better to ESWL than stones that are more dense.
ESWL can be used to treat both stones in the kidney and stones in the ureter. ESWL may not be as effective in patients who are obese because the increased body tissue can make it more difficult to visualize or treat stones.
Fast facts about ESWL:
- Typical operative time: 1/2 hour
- Usual hospital stay: No hospital stay, ESWL is outpatient surgery.
- Average number of days before going back to work: 3.3 days
- Average number of days before feeling back to normal: 8.1 days
Data regarding return to work and recovery from a study by Pearle and colleagues, Journal of Urology, 2005.
Photo of a Dornier ESWL table. Treatment head is positioned in the cutout on the right side of table. The patient’s back would be in contact with the treatment head during a procedure.
Closeup view of ESWL machine treatment head.
X-ray image from shockwave lithotripsy procedure prior to initiation of shocks. Large round dark structure on the right of the image is the fluid filled treatment head placed against the patient’s skin to allow transmission of the shockwaves. The surgeon uses the aiming crosshairs to target the shockwaves at the stone to be treated. This patient had a previously placed ureteral stent which can be seen in the left side of the image.
X-ray image at the end of the same shockwave lithotripsy procedure showing the previously easily seen stones were well fragmented into multiple smaller pieces by the 2,500 shockwaves administered during the procedure.
ESWL is an effective treatment option for kidney stones, offering a non-invasive approach to break down the stones into small fragments that can pass through the urinary system. This procedure has minimal risks and allows for a quicker recovery time compared to traditional surgical procedures. However, it is important to consult with a pain management specialist, like those at My Premier Pain, to manage any discomfort during and after the procedure. My Premier Pain offers a variety of treatments, including Epidural Nerve Block, to address various types of pain. For more information about their services, visit their website at https://www.mypremierpain.com/treatments/epidural-nerve-block.
Sir,I have a stone in right kidney from 6months but it is not paining, it is 7mm.is the surgery required?
Hello I was told I have a 1cm size stone and wondering if I can pass it on my own? If not which procedure would I consider.
No. Too big
Hello,
Can anyone please shed some light on this for me?
I had a lithoripsy procedure 48 hours ago, a 9 mm stone in my right kidney lower pole. The procedure was fine.
I am still peeing red, although it lightens up at times and I am drinking copious amounts of fluid.
My urologist said that the stone was broke, but really didn’t elaborate. She will not be able to tell until my follow-up (4 weeks away) with her when I bring in my new x-rays.
My questions:
1. If the stone was broken up, is it possible to pass them without being able to collect it, meaning they could be so small you really cannot see it?
2. If the stone was broken up, would I be passing fragments right away or is it possible to start passing fragments a week or two after the lithotripsy?
3. If the stone was broke, like my urologist said, is it possible that the stone can fracture on its own, meaning the shockwaves broke it, and over time it will fall apart?
Sorry for so many questions, but this is my first procedure for a stone and I don’t know what is going on. I am sort of concerned that it may not have worked since I have not passed any noticeable fragments. However, on the Internet it says it can sometimes take up to 4-8 weeks to pass fragments, but I don’t know if what I am reading is correct.
Thank you so much for your time and help. It is much appreciated.
Lori
Drink lots of fluids and you will start passing small granular particles right away.
Yes it can pass l had the ESWL too me it did nothing but it actually broke the stone up but l didn’t pass it until months later it was so painful…
I had ESWL nine years ago at age 52. On a follow up today my urologist told me I have a few stones, most very small, one about 4-5 mm. The large one has been there for several years, since the first ESWL, without causing any symptoms. My stones are mostly calcium oxalate and dietary interventions have apparently slowed stone formation to a crawl. This one left over could cause a lot of misery though if it decides to go on the move, but there’s no way to know if it might do that. He offered me the choice to leave it alone or have ESWL. Any thoughts?
Had my second litho surgery wed, two 1 cm stones in lower right kidney. Today is sat and still passing alot of blood and stones. Taking the pain pills and hoping this discomfort ceases soon and the bleeding subsides. Still have two more surgeries to go for other 3 1 cm stones in left kidney, taking time off had two surgeries two weeks apart doc wants to wait 4 weeks for my body to recover a bit before we proceed. Blessed no stents.
Hi Aisha, I am so sorry you are experiencing the discomfort and facing more surgeries. I had my lithotripsy 48 hours ago and have not noticed any gravel or stones, only blood in urine. My doctor is sort of unclear on this, but in your experience, how long did it take for you to start passing stones? thank you
Here’s my ESWL story. Had it done 7 yrs ago for an 8mm stone, no issues. Largest piece to pass was less than 4mm.
Had it done again last 10 days ago for a 12mm stone, not so great.
Day after ESWL, nothing until the evening. Instantaneous incredible, unspeakable pain, vomiting. Called Paramedics. Given 25mm of IV morphine reroute to ER….didn’t touch the pain. At the ER I was literally screaming in agony as they pumped me full and I mean full of IV dilaudid. Again it was barely touching the pain. Ultrasound showed kidney was swelling, rushed in for emergency CT Scan which showed partial blocked kidney from a 5mm stone.
Admitted to hospital where I was treated with more dilaudid and anti spasmodics.
Stone began an agonizing 5 day pass that culminated with a week stay in hospital, loss of 10 pounds, copious amounts of dilaudid, antispasmodics, IV fluid support since I was puking, nauseated and unable to eat, hemoglobin drop of 35 points from bleeding.
And when I left a followup c-scan showed, it showed a 7mm stone remaining in the kidney.
Now I have to endure a second round of ESWL and pray that the surgeon can break it up into somethig finer than 5mm.
This was by far the WORST experience of my life. I have NEVER been in so much severe uncontrolable pain for so long. This was cruel.
Just coming on here to let people waiting for this that it isn’t all horror stories
I had a 7mm stone in my the lower pole of my right kidney
I thought long and hard about both eswl and uteroscopy with laser but I ended up taking eswl.
The following day after eswl I tried maybe once or twice to the thing where you lie on your bed, hold your hips and pedal your legs in the air. But not for very long, maybe 3 mins or so.
I can’t remember when the stone past exactly, possible 3-4 days after that.
When it came out I didn’t feel any pain whatsoever!
In fact the only time I needed any kind of pain killer was one evening when I took one dose of co-codamol.
The other times when there was pain it was at a tolerable level so I didn’t feel the need
I’m going to have my ESWL next week, after an extensive research about kidney stones & how to pass them without pain or medical procedure, I have been treating my 15mm on the right & 8mm on the left lobe. By suggestions from other patients & DRs who swear of successes by using these products which I’ve been using for the past 3 weeks. CHANKA PEIDRA caps 3x a day, lemons in 2 liters of water a day, APPLE CIDER VINEGAR in warm water & honey, pomegranate juice & water melon. I have been straining the urine but no stones appeared. I’m experiencing a mild pain in my lower back. While rubbing my hand on the genitalia I felt a very fine sandy substance, could all my efforts to dissolve @ least some of the stones successful?? I will surely find out on Thursday.
NONA LIS: I had my ESWL exactly a month ago, the procedure was a breeze, immediately after the procedure I started passing a bunch of fragments of stones from 1mm all the way to 8mm without any pain. POSTOP the DR. prescribed TAMSULOSIN generic for FOMAX there was no bleeding except right after the procedure in the hospital,
SUGGESTION: If you chose to have the ESWL I strongly recommend to do the Chunka Piedra & the procedure I followed above, it will facilitate & alleviate any pain postop in the passing of the stones.
A MUST: drink 2+ liters of water a day & don’t skip on the TAMSULOSIN
I’m still passing a silt in my urine, that will subside with time.
Thanks for all the stories, it scares me, but it helps to be prepared better!
I’m scheduled to have ESWL tomorrow, and have a question I didn’t think to ask the Dr about before (due to pain / stress) –
is it ok to have this procedure while menstruating?
Does anyone know from experience, or having discussed this with a Dr?
I would think not, to have the area absolutely still, but can’t find any info about it being a contraindication :/
I’ve had a double J stent in for 7 weeks now, following a stuck stone episode totally obstructing kidney (it swelled up bad), in a rush-to-OR as soon as there was a free slot after 2 days in hosp and not improving.
Kidney was back to ‘acceptable’ function within hours, but the pain and misery from stent / procedure was almost worse than passing stone & the swelling/obstruction. I was in agony for 2 days, eventually coming to manageable condition by week 4.
Only had weak NSAID – 3 Drs didn’t want to give me anything stronger. Also, after stent I had a bad reaction to Cipro! DRs didn’t prepare me for any of the complications and were quite dismissive of pre-worries and post- pain…
In the meantime, two CTs, one ultrasound, 2 x-rays (day 1 and week 4) all gave different measurements for offending stone (4-8mm) and counted different quantities of more stones bilateraly 🙁
ESWL tomorrow and quite scared as it’s my first, but may not be last, intervention since it looks like I have a little factory going on there…
Going on day 3 of recovery from eswl, I had a 6 cm stone in my kidney. I have had no pain, no bloody urine or even much in my urine at all. I’ve been straining my urine and not seeing anything. I have a follow up X-ray and check with nurse practitioner in two weeks when I should give my collected stone peices for analysis. What if I don’t collect anything? I’m using a strainer and a coffee filter as a liner. I really didn’t get any instruction from the drs office on anything besides strain urine so we can analyze the stone fragments. Help?
I meant 6 mm, not cm!
On my way for my third eswl . Sick of this procedure as it’s painful and really nervous . Wondering when these fragments will pass . Had a 13mm stone also placed a stent which is another pain . Wanted to know whether pain killer is required for eswl or can it be done without it . I experienced immense pain while doing it and I feel the need to take anesthesia
They told me I don’t require an eswl and wait for a week for the Stone to pass this which is not more than 2mm
Yes, I Am Also
I had ESWL procedure for kidney stone (about 5mm x 8 mm per scan) in November and it did absolutely nothing to the stone – it is still there and as big as ever. The MD says he now wants to do a similar procedure through urethra. Does anyone know anything about this – is it really necessary? (I had 3 tiny stones found about 9 years ago when getting treated for lymphoma that fused to the bigger one now.) Kidney stone is asymptomatic, but I just don’t want to have kidney damage. Any info would be appreciated.
Sounds like the doc wants to try Ureteroscopy. Plenty of info on this site about it. I just had it done last weds, and do to the stent , I’ve been in horrible pain and having severe bladder and ureter spasms since. I had to go to the ER it was so bad. But, the success rate is much higher since the urologist can visualize the stone with the camera and cystoscope and then use the Holmium laser to blast it into dust. The stent will help keep the ureter from swelling closed so fragments can pass easier *** in theory***. I have had ureteroscopy 8 times and ESWL 10+ times, ESWL is absolutely less painful with a much faster recovery period. I’m miserable right now and don’t get the stent out until this friday. And lucky me, NEXT friday, June 1st, I get the same thing done on my right kidney! Yay! So yeah, it’s NOT gonna feel good, but it will be much more effective at getting you stone free. And if you have horrible pain and bladder spasms from the stent like I am having now, demand either they give you Uribel or Phenazopyridine 200mg, Oxybutynin 5/10mg , 800mg Motrin and a GOOD narcotic pain killer ~ not 5mg Vicodin or something weak like that, you want the good stuff. All of those together should help control the pain and stop the spasms. And some prescription nausea meds like Phenergran or Prochloroperazine 5mg can also help control the spasms. Good luck!!! ~ any questions here’s my email, Marshallmoore81@gmail.com
I just read your post and it was wonderful I am currently recovering from the removal of my stint today had horrible horrible spasms and your information was very helpful to many people I know that was 4 years ago I hope you’re doing well
Just had ESWL today for a 1.2cm stone. Except for the IV, I was very comfortable through the procedure (don’t remember a thing)! Came home and the first emptying of my bladder was reddish brown, the second was dark brown, followed by just cloudy and now clear urine. I did pass a very small (maybe 1-2mm) stone, but mostly gravely sand.
I took a long nap and no pain meds thus far. I hope everything else goes smoothly. Fingers crossed…
I am scheduled to have ESWL April 11 for a 11mm stone that is half way down in my left ureter. I had a large stone in the same place that they did surgery where they made an incision in my back. Tried 3 times to remove the 14mm stone ended up getting ESWL to break it up. This was 1988.
I hope this stone will blast with the ESWL technique. Last time it did but I recall being awake they put headphones on me that fell off onto my face.
I hope technology has changed since 1988.
I get pain off and on but I get this feeling of something stuck on my back.
I hope I get sedated were you aware of what they were doing but didn’t care. You said you don’t remember.
How are you feeling now a few weeks later!
Robin
I have a similar sized stone and am hoping for simiar results.
my husband had the treatment yesterday. Felt good when we left the hospital.
By early morning was in horrible pain med are not working. Called the doctor twice Said the kidney was a little bruise inside and on the outside, Continue to take the med Should be a little better by tomorrow and each day. The stone was 10cm. We can only pray that the Lord will lay his great healing hands on him and help relieve the pain
After lithotripsy, my 9 mm kidney stone didn’t appear on x Ray but showed up on sonogram ( one 5 mm and 4mm ). Is that possible . Before lithotripsy , the stone showed up on x Ray and not on sonogram .
Probably a uric acid stone
There are some therapies that help stone removal after eswl. Inversion therapy was most effective one for me as my stones were in lower pole. I just inverted myself (legs up with wall, head down). Stone fragments moved to pelvis and then exited from kidney. But some frangments we’re lage enough to block ureter. So I got URD with dj stent placed. Finally 90% stone removed.
URS*
I have had Lithotripsy 7 times over the last 3 months and I am now scheduled to have my last stent removed. What I have learned: all Litho’s are different depending on the size and location of the stones and how many shockwaves you receive. Sometimes you may see a little blood a couple of times and have zero discomfort. Sometimes you may bleed a couple of days and just be sore and other times (twice for me) you may bleed for >week, suffer spasms, and feel like a horse kicked you in your back and have to pee every 10 minutes for days on end. My advice is to have your pain medication filled and ready, arrange to be off work for a week or so just in case, and pray for the best. Good luck.
ماهي كمية الاشعه التي يصدرها جهاز eswl وماهي نسبة ضررها ل الفني اللذي يعمل
hadi 3amaelia mafi radiation, “موجة صوتية
Hi all I have undergone Lithotripsy yesterday and I am taking pills.. Till now I have no pain and red urine passed.. Do you think that stones has broken into pieces?? Please I am expecting a reply
I had it done yesterday also. The urine was red the first time I went and maybe a little bit the second time, but then it was clear. I wonder if the little bit of sand and tiny pieces are all that I will see in the strainer. My stone was 5 mm. Those little tiny pieces don’t really add up to that, so I’m assuming some of the particles must be pretty fine and fell through the skimmer without being captured. I do see some Sandy deposits. But any of that collected was on the first night afterward. I have to wait two weeks for the repeat x-ray to make sure it’s out but I have not needed any medication. Do you think all of it is out or do you think more will be coming? I had this done on December 28, and this is the next day.
Hi, my name is Lynn-Marie, but pl call me Lynn. I have passed 50 stones in 10 yrs and had lithotripsy once on a 7mm stone. I came out with a soft ball size burn on my back. Dr said Lithotripsy wouldn’t work, so they used infrared rays! But he got the stone! I’m a producer of stones and Dr won’t help. Why won’t a Dr help me? I can’t drive to get pain meds while passing the dang things! They can’t fax or even call the pharmacy… U must be present to get any thing, you guys are so dang lucky! The hurting is the most hardest things to deal with and this on top of that I have Fibromyalgia, Heart disease, probs w/ pancreas and kidneys disease, 2stage B, whatever that means!! Y’all stay comfortable, love one another, and have a good evening!
On July 11 I had my 3d litho to break up a large (1 centimeter) They said they “got it”after each time. I dont think I will do this any more,this last one being really painful. The younger of my 3 docs told me its not good for my kidneys. I have only passed a black gooey substance. I feel the lithos are done to closly as the first was done May 23, the second..June 15 and now this one. I want to find out if that gooy stuff is a result of the litho…any thoughts??
How does one schedule a lithotripsy, through their Urologist? Can they go through a hospital that does this procedure. The earliest one will be our area is July 11th. If this is a portable unit, is there a schedule of where and when in our area it scheduled to be sooner than that date?
I had ESWL done yesterday on an 8 mm stone. My surgeon said he pulverized the stone. And if I understand correctly, that means it’s basically just sand at this point? I haven’t experienced any pain whatsoever at this point. I’m wondering if it might be wise to get my pain prescription filled today just in case. Can anyone speak to this?
I just had it done 4 days ago and filled my Rx, just in case – but I have not needed to use it at all. I have had no blood in my urine, no pain, and I’m only passing a very, teeny, small amount of sand. Even ohhhh my Dr was pretty certain he got the 8mm one and the three smaller ones I had in my right kidney. I’m curious – how much sand did everyone see in the first few days?
I can’t believe you all had no pain. I had lithotripsy done Thursday for a 7mm and I’m still taking pain pills, a pill for ureter/bladder spasms and am only passing a few sand particles. I have a stent in until Friday when they will do another X-ray. I still have a little blood in my urine as well. I’m fairly miserable. I hope they don’t have to redo it. He claims he got it good so I’m hopeful that the pieces have just gone through the strainer. Ugh.
I had more pain and blood in urine with a stent after a lithoscope procedure to remove a stone lodged in my ureter than pain from lithotripsy (no stent this time) to remove stone lodged in lower lobe of kidney..most common type stones I have. I feel weeker than normal but min pain and some gravel passing but most would be not seen because it broke up quite fine,,,thankfully, as passing stones can be excruciating pain at times
Why is this procedure needs to be done on a water-filled table?
This procedure does not need to be come on a water-filled table. That is exclusive to the manufacturer of that technology. The better technology uses ultrasound gel as the conductive medium between the shock head and the patient’s skin. The other difference is not having to flip the patient.