Extracorporeal Shock Wave Lithotripsy


Extracorporeal shock wave lithotripsy (ESWL) is a common technique used to treat kidney stones.

It’s a procedure that involves the use of high-energy waves called shock waves to target hard mineral deposits and break them up so they can naturally make their way through the urinary tract and out of the body.

ESWL a less-invasive approach to dealing with kidney stones that are either too large to pass or not moving along on their own.


How is Extracorporeal Shock Wave Lithotripsy Done?

There are two approaches to using sound waves to target kidney stones. With one method, a patient sits in water. X-ray or ultrasound images are then used identify where the stones are located. The stones are then targeted with shock waves once the body is placed into the correct position.

The more common approach to extracorporeal shock wave lithotripsy involves a patient resting on a soft cushion while strong pressure waves are passed through the skin in the area where the kidney stones are located. It usually takes a few thousand rapidly delivered shock waves to effectively crush deposits. This approach to treatment is usually completed in about 45-60 minutes. Some type of anesthesia is usually used the reduce discomfort as the procedure is performed.

Preparing for ESWL

Prior to recommending ESWL, a urologist normally performs tests to check kidney functioning and urination ability and to rule out other possible causes of symptoms suggesting kidney stones. Once it’s confirmed that kidney stones are causing a patient’s symptoms, the next step is usually to determine where they are located and how big they are so shock waves can be targeted at the right area.

Who is a Candidate?

Some kidney stones can be treated with medication, although about 90 percent of mineral deposits of this nature can be passed through the urinary system without any treatment. Whether or not ESWL is recommended will depend on factors such as:

  • A patient’s physical size (for the water bath method)
  • The ability to clearly view the kidney stones on the X-ray monitor
  • A patient’s overall health along with the characteristics of the stones
  • Responses to previous attempts to treat kidney stones

Possible Benefits Associated with ESWL

The main benefit of extracorporeal shock wave lithotripsy is the possibility of avoiding surgery for kidney stones. Patients who respond well to this approach to treatment may also benefit from fewer complications, less discomfort, and faster recovery times. Additional treatment is sometimes needed if fragments are left behind that can’t be naturally passed.

About a million Americans are affected by kidney stones each year. It’s estimated that anywhere from 70 to 90 percent of “good candidates” for extracorporeal shock wave lithotripsy treatment are free of stones shortly after treatment. Success rates with ESWL tend to be higher when mineral deposits are higher up in the urinary tract. Your urologist may be able to make personal recommendations on how to reduce the risk of recurrence by collecting a 24-hour urine sample to find out what’s likely causing kidney stones to form in the first place.