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ESWL (Shock Wave Lithotripsy)

A non-invasive method that fragments kidney and ureter stones with high-energy sound waves delivered from outside the body.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Üroloji department. Book Appointment →

What is ESWL (Shock Wave Lithotripsy)?

Extracorporeal shock wave lithotripsy (ESWL) is a non-invasive treatment in which kidney and ureter stones are fragmented into small pieces by high-energy acoustic shock waves delivered from outside the body, after which the fragments are passed in the urine.

The procedure is usually performed on an outpatient basis under sedation or local analgesia; general anesthesia is rarely needed. Fluoroscopy or ultrasound guidance is used to localize the stone.

ESWL success depends on stone size, location, density (Hounsfield unit) and patient body habitus. Best results are obtained in renal stones smaller than 10 mm; hard-composition (cystine, calcium oxalate monohydrate) stones respond less well.

Symptoms

ESWL is not a disease but a method of stone treatment
Transient flank pain and hematuria are expected after the procedure
Colic pain may occur as fragments pass
Skin bruising at the procedure site (rare)
If fever develops (fragment obstruction or infection), urology evaluation is required

Risk Factors

Bleeding disorder or anticoagulant use (contraindication)
Pregnancy (absolute contraindication)
Bowel or large vessel in front of the stone
Pacemaker carriers
Severe obesity (technical difficulty)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Urology evaluation when kidney or ureter stone is diagnosed
  • Fever and severe pain after ESWL (urgent)
  • Follow-up imaging to assess whether the stone has fragmented
  • Metabolic workup for recurrent stone formation

Treatment Methods

01
ESWL session planning: 1-3 sessions according to stone size and location
02
Analgesia and light sedation if necessary during the procedure
03
Alpha-blocker therapy after ESWL: facilitates passage of fragments through the ureter
04
Adequate hydration: at least 2-2.5 liters of fluid daily to help expel fragments
05
Conversion to ureterorenoscopy (URS) or PCNL after failed ESWL
06
Prevention of recurrent stone formation by metabolic evaluation

Which Department to Visit?

You can visit our Üroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.