Lithotripsy, also known as extracorporeal shock wave lithotripsy (ESWL), is a procedure used to treat kidney stones. It uses high-energy sound-waves to break down the kidney stones into tiny fragments, which are then able to be flushed out of the body in the urine.
The treatment is routinely performed as an out-patient or day-case without the need for anaesthesia, and it usually takes between 20 and 30 minutes. During the procedure the patient will lie on their back on the bed. An X-ray or ultrasound will be used to detect the exact location of the kidney stones.
Once the stones are located, a gel is applied to the skin to provide good contact with the lithotripter probe. The probe focuses sound waves at the stones through the skin, no cuts are made. Although the sound waves themselves do not hurt, most people feel an unusual and uncomfortable sensation as the stone is broken up. The consultant will provide the patient will pain relief to make the procedure more comfortable.
After the procedure, the patient may have some pain and will be given some painkillers to relieve this. Patients will be advised to drink fluids regularly for the next 48 hours to help flush the kidneys and lower the risk of developing a urinary tract infection. Patients may have some blood and/or fragments of broken stone in their urine during this time, this is normal.
The success of the treatment will depend on the density, size and position of the stone. Many lithotripsies are not successfully completed on a single visit and may need to be repeated, the consultant will discuss this in detail before the procedure.
Lithotripsy is a commonly performed and generally safe procedure. For most people, the benefits of having this non-surgical treatment for kidney stones are much greater than any disadvantages. However, like all medical procedures, there is an element of risk. Specific complications of lithotripsy are uncommon, but it is possible to develop a urinary tract infection afterwards, requiring treatment with antibiotics. In rare cases, stone fragments can block the tubes that carry urine from the kidneys to the bladder causing severe pain – patients should contact their consultant if they have any pain that doesn’t settle with painkillers.