Shockwave lithotripsy (ESWL)

Diagram of ESWL

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 ESWL table

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.

Photo of ESWL treatment head closeup

Closeup view of  ESWL machine treatment head.

Xray of ESWL

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.

Xray of ESWL after

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.

118 Responses to Shockwave lithotripsy (ESWL)

  1. Mike Walker says:

    I had my shockwave treatment approx 6 months ago It broke up one stone but I still have one. I was in serious pain for several days and had to go to A&E several times. The treatment damaged my kidney causing it to bleed and swell it is now enlarged. I have had several CT scans and am awaiting final ones result and decision on what to do next. I have a constant pain in this kidney and take daily pain killers. The doctor says he cant do shockwave again and will have to use a laser to destroy the remaining stone. I wouldnt advise this treatment !

  2. David says:

    Just had the procedure on Friday after a very painful week of the 8mm lodged in my left side. Procedure went well and did feel relief immediately –first 24 hours post procedure were more about the groggy effects of general anesthesia and some soreness, Still have not passed any of the particles and last night the more intense pain re-emerged. Really hoping this is just a part of the healing process and this pain will pass today. I suppose the area where the stone was lodged remains tender for some time –at least hoping that is what is going on and not that another chunk is now lodged in the same place. Anyone else have intense pain post procedure that was in the same place pre-procedure?

    • Corey says:

      Hi David,

      I had the procedure on 4/21. I felt immediate relief as well. There was a bit of stone like pain the second day, but its gone. The most uncomfortable and slightly painful thing has been the stent. I am told I will have to keep it in till 5/7. On 5/6 I go in for another scan before stent removal. The doctor said there may be a possibility of larger stones that need another treatment. But in my case he said they were broken up pretty well.

      My stone was 9mm. It took a day before I saw fragments show up. I had stones before, but this one was six months of unknown off and on soreness. I had hip reconstruction in Jan, which I figured might solve the pain on my left side. Unfortunately it was still there and not hip related. After the lipotripsy I was able to walk with zero pain.

      Now I just count down the days till the stent removal!

      Hope all is working out for you.



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