How Extracorporeal Shock Wave Lithotripsy Works

Extracorporeal Shock Wave Lithotripsy (ESWL) is a non-invasive procedure used to treat kidney and urinary stones. This technique uses high-energy shock waves generated outside the body, which are then precisely targeted at the stones using ultrasound or X-ray imaging. The shock waves pass through the body and break the stones into smaller fragments. These smaller pieces can then be naturally expelled through the urine over time.

The procedure typically involves lying on a water-filled cushion while the shock waves are delivered. One of the major advantages of ESWL is that it causes minimal trauma, involves little pain, and allows for a quick recovery with relatively low costs. Patients often return to their normal activities within a day or two.

However, it's important to understand that ESWL only breaks the stones into smaller pieces. The fragments still need to be expelled from the body, which often requires medication, physical activity, and specific body positions to help move the pieces out through the urinary tract. Not all types of stones are suitable for this treatment, and success can vary depending on the size, location, and composition of the stones.

There are also potential risks associated with ESWL. Although the impact on kidney function is usually minor, repeated sessions or excessive energy levels can lead to complications such as kidney damage, internal bleeding, or even high blood pressure. Before undergoing the procedure, patients must undergo several evaluations, including blood tests to check clotting function and to rule out existing urinary tract infections. If an infection is present, it must be treated first to avoid spreading it during the procedure.

If after two or three sessions the stones have not been fully fragmented or expelled, doctors generally advise against further ESWL treatments. Too many sessions can increase the risk of long-term kidney damage. In such cases, alternative treatments like ureteroscopy or percutaneous nephrolithotomy may be considered for more effective stone removal.