What to expect with Lithotripsy

Noninvasive Treatment for Kidney Stones

Extracorporeal shock wave lithotripsy (SWL) is a technique for treating kidney stones and stones in the ureter that avoids the need for surgery. In SWL, high energy shock waves are passed through the body and used to break kidney stones into pieces as small as grains of sand. These small pieces can then pass from the body along with the urine. 


During lithotripsy, a special machine called a lithotripter sends shock waves to the stone. The waves pass harmlessly through the skin and muscles of your back and focus on the stone. There are two ways to remove kidney stones using shock wave treatment. In one method, the patient is placed in a tub of lukewarm water and x-rays or ultrasound are used to pinpoint the location of the stones. The body is positioned so that the stones can be targeted. In the second, more common method, the patient lies on top of a soft cushion through which the waves pass. Thousands of shock waves are needed to crush the kidney stones and the procedure usually takes about 45 to 60 minutes. This is the form of therapy provided at MetroLithos many facilities, (see links below). Because this treatment helps avoid surgery, complications, hospital stays, costs and recovery time are reduced. However, not all types of kidney stones can be treated with SWL.

Some type of anesthesia, (local, regional or general), is used to help the patient remain still and to reduce discomfort. While patients used to routinely remain in the hospitalized for a day or two following treatment, currently the procedure is usually performed on an outpatient basis. Following treatment, the patient can move about immediately. Many patients fully resume daily activities within one to two days and no special diet is required. Naturally, drinking plenty of water helps the kidney stone fragments to pass. The fragments begin to pass soon after treatment and may continue to do so for a number of weeks. Pain following lithotripsy sometimes occurs as these fragment pass, but mild pain medication and drinking lots of water will help relieve symptoms.

As most patients have small amounts of blood in the urine for a few days and the tiny fragments may cause discomfort as they pass. If a stone is not completely shattered, additional treatments may be needed. Not all stones are amenable to treatment with ESWL and the size, location and composition of the stones must be taken into account when exploring treatment modalities. Also, the stones must be clearly viewed by x-ray so the shock waves can be targeted accurately. If anatomical abnormalities prevent proper targeting of the kidney stone(s) then other treatment methods will be considered.

In those patients thought to be good candidates, 70 to 90 percent are found to be free of stones within three months of treatment. The highest success rates seem to be in people with mobile stones that are located in the kidney and upper ureter. Occasionally, some patients may still have stone fragments that are too large to be passed after treatment. If symptoms persist, these can be treated with lithotripsy again.