Shock wave lithotripsy

Shock wave lithotripsy is a way to treat kidney stones without surgery. It is also called extracorporeal shock wave lithotripsy, or ESWL. This treatment uses sound waves to break kidney stones into tiny pieces. These pieces can then pass out of the body in the urine.

You may get medicine to make you relaxed and help with pain or discomfort.

You will lie on a table. The lithotripsy machine directs sound waves at your stone through a cushion.

The doctor may use a small, flexible tube called a stent. The stent will let the stone pass more easily.

Most people are at the doctor's office or clinic for about 2 hours. You can go back to your normal routine right away.

Most stones pass within 24 hours after the procedure. But it can take as long as several weeks. If you have a large stone, you may need to come back for several treatments. In some cases lithotripsy does not break up the stones. Surgery may be needed to remove them.

Shock wave lithotripsy may be used on a person who has a kidney stone that is causing pain or blocking the urine flow. Stones that are between 4 mm (0.16 in.) and 2 cm (0.8 in.) in diameter are most likely to be treated with ESWL.

The procedure may work best for kidney stones in the kidney or in the part of the ureter close to the kidney. Your surgeon may try to push the stone back into the kidney with a small tool (ureteroscope) and then use the procedure.

Shock wave lithotripsy is usually not used if you:

• Are pregnant. The sound waves and X-rays may be harmful to the fetus.
• Have a bleeding disorder.
• Have a kidney infection, urinary tract infection, or kidney cancer.
• Have kidneys with abnormal structure or function.

Shock wave therapy uses shock waves to break a kidney stone into small pieces that can more easily travel through the urinary tract and pass from the body.

• You lie on a water-filled cushion, and the surgeon uses X-rays or ultrasound tests to precisely locate the stone. High-energy sound waves pass through your body without injuring it and break the stone into small pieces. These small pieces move through the urinary tract and out of the body more easily than a large stone.
• The process takes about an hour.
• You may receive sedatives or local anesthesia.
• Your surgeon may use a stent if you have a large stone. A stent is a small, short tube of flexible plastic mesh that holds the ureter open. This helps the small stone pieces to pass without blocking the ureter.

Shock wave treatment works for most people who have small kidney stones—either in the kidney or in the ureter.

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what procedure is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your procedure. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your procedure. Your doctor will tell you if you should stop taking any of them before the procedure and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Activity

• Rest as much as you need to after you go home.
• You may do your regular activities. But avoid hard exercise or sports for a week. Wait until there is no blood in your urine and the stent is out.

Diet

• You can eat your normal diet.
• Drink plenty of fluids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also be given instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Be safe with medicines. Read and follow all instructions on the label.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take acetaminophen (Tylenol). Do not take ibuprofen (Advil, Motrin) or naproxen (Aleve), or similar medicines unless your doctor tells you to.
  • Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.

Other instructions

• Urinate through the strainer the doctor gives you. Save any stone pieces, including those that look like sand or gravel. Take these to your doctor. This will help your doctor find the cause of your stones.