Shock wave lithotripsy (ESWL) for kidney stones

Why it may be used

ESWL may be considered for certain stones based on their size, location, and composition, and on the person’s anatomy and health. A clinician weighs it against other options such as ureteroscopy.

Who it may not suit

It may be less suitable for very large or hard stones, some stone positions, pregnancy, certain bleeding risks, or particular body characteristics. Suitability is an individual decision.

What happens

Imaging locates the stone, and shock waves are focused on it to break it into pieces. Pain relief or sedation is used depending on the setting. The procedure is often done as a day case.

Recovery and follow-up

Fragments pass over the following days to weeks, which can cause discomfort and blood in the urine. The team advises on fluids, pain relief, warning signs, and follow-up imaging to confirm the stone has cleared.

Risks and possible side effects

Possible effects include pain as fragments pass, blood in the urine, bruising, infection, fragments that do not clear (sometimes needing another treatment), and, uncommonly, injury near the kidney. The treating team provides individual estimates.

Questions to ask a clinician

• Is my stone suitable for shock wave lithotripsy?
• How does it compare with ureteroscopy for me?
• How many sessions might I need?
• What symptoms after treatment need urgent attention?
• How will we confirm the stone has cleared?