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What is shock wave lithotripsy?
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Can shock wave lithotripsy break up a stone?
Shock Wave Lithotripsy (SWL) is the most common treatment for kidney stones in the U.S. Shock waves from outside the body are targeted at a kidney stone causing the stone to fragment. The stones are broken into tiny pieces. lt is sometimes called ESWL: Extracorporeal Shock Wave Lithotripsy®.
- Ureteroscopy
For stones in the kidney, shock wave lithotripsy (SWL) is...
- Percutaneous Nephrolithotomy
These procedures are treatments for kidney stones that are...
- Lithotripsy
Extracorporeal shock wave lithotripsy (SWL) is a noninvasive...
- Ureteroscopy
- Overview
- What is lithotripsy?
- Success rates
- How to prepare
- What to expect
- Recovery
- Risks and side effects
- Limitations
- Summary
Lithotripsy is a type of medical procedure. It uses shock waves or a laser to break down stones in the kidney, gallbladder, or ureters. The main types are extracorporeal shock wave lithotripsy (ESWL) and laser lithotripsy.
The remaining particles of small stones will exit the body when the person urinates.
It is common to develop stones in the kidneys, gallbladder, or ureters.
Sometimes, stones are small enough to leave the body during urination without a person noticing. However, large kidney or ureter stones can cause pain and block the flow of urine.
If stones do not pass, they can damage the kidneys and urinary tract. When medications do not help, a lithotripsy procedure can break the stones down into smaller pieces so that they can come out in the urine.
The two main types of lithotripsy are extracorporeal shock wave lithotripsy (ESWL) and laser lithotripsy. Laser lithotripsy is sometimes known as flexible ureteroscopy and laser lithotripsy (FURSL) because doctors use a tool called a ureteroscope.
The success of any one method will depend on stone composition, density, size, and location.
One systematic review found that FURSL had a success rate of 93.7% for stones around 2.5 centimeters in size. The study reported that 10.1% of people experienced some complications, however.
Before the lithotripsy procedure, a doctor will run tests to determine the number of stones a person has, as well as their size and location.
It is likely that the doctor will use a non-contrast CT scan to diagnose kidney stones because this test is highly sensitive and specific.
They will also use a standard abdominal X-ray known as a kidney, ureters, bladders (KUB) to find calcium-containing stones.
A person should let the doctor know if they are taking any medications in advance. Before the procedure, they may need to stop taking certain medications, including blood thinners and over-the-counter pain relievers such as aspirin and ibuprofen. This is because these can interfere with the ability of the blood to clot.
Blood clotting is essential to stop any bleeding that might occur during or after the procedure.
Lithotripsy usually takes place under general anesthetics, which means that the person will be asleep and will not feel any pain. Typically, people will need to fast for 8–12 hours before receiving anesthetics.
Once in the procedure room, the doctor will place an intravenous line in the person’s arm to administer anesthetics and provide pain medication.
For ESWL, the person will lie on the table with the lithotripter positioned to target the location of the stones.
The doctor will pass a water-filled cushion between the body and the lithotripter to conduct the shock waves properly. The shock waves are not painful.
The doctor may also place a stent in the ureter to help the broken stones pass.
After the person has woken up from the anesthetics, the doctor will monitor them for at least 1 hour to confirm that they are comfortable and stable enough to go home. The doctor will provide care instructions and pain medications before discharging them.
It may take a few weeks for the person to pass all the stone fragments, and it is not unusual for them to see blood in the urine for the first few days after the procedure.
It is also common to experience pain in the back and flank, but pain medications can reduce the severity of this pain. Some people may also experience mild bruising on the skin where the shock waves entered the body.
It may be over a week before a person feels able to return to work following a ureteroscopic procedure.
Side effects tend to be minor due to ureteroscopy advances such as smaller cameras and more precise lasers. In fact, some people could return to work within 1–2 days of the procedure.
However, full recovery may take longer than this for some people.
People often experience bruising and soreness after shock wave lithotripsy.
Fever or chills may occur after ureteroscopy and shock wave lithotripsy. These may indicate an infection, so a person should speak with a doctor if they experience fever or chills.
Heavy bleeding after lithotripsy is uncommon.
If stone fragments get stuck, there may be a blockage in the ureter. If this is the case, a doctor may perform an additional procedure with a ureteroscope to remove the fragments.
Lithotripsy procedures cannot treat large or hard stones.
Also, ESWL may not benefit people obesity, as the shock waves may not be able to reach the stones.
Doctors do not recommend lithotripsy procedures for pregnant people, as they may pose a risk to the fetus.
Some stones will require more than one procedure, and, in some cases, a doctor may need to place a stent and remove it once the stone fragments have passed.
Lithotripsy uses shock waves or a laser to break down stones in the kidney, gallbladder, or ureters. There are two main types of lithotripsy — ESWL and FURSL — and the procedure usually lasts between 30 minutes and 2 hours.
If a person experiences fever or chills after undergoing ureteroscopy or shock wave lithotripsy, they should contact a doctor. These may indicate infection.
What You Need to Know. ESWL is a noninvasive procedure that breaks down stones in parts of the urinary system, in the pancreas and in the bile ducts. It uses shock waves that are aimed at stones, with the help of X-rays or ultrasound. Stones in the kidneys and ureter often pass on their own after EWSL.
Extracorporeal shock wave lithotripsy (ESWL) is a common, nonsurgical procedure to treat kidney stones. It uses high-energy shock (pressure) waves to break up stones. Tiny pieces of the stones can then move through your urinary tract and out of your body more easily.
Shock-wave lithotripsy (SWL) is done with a machine that can break kidney stones from outside the body. To break the stone, focused shock waves (short pulses of high energy sound waves) are transmitted to the stone through the skin. The stone absorbs the energy of the shock waves and breaks into smaller pieces.
The shock waves, which are generated by a machine called a lithotripter, are focused by x-ray onto the kidney stone. The shock waves travel into the body, through skin and tissue, reaching the stone where they break it into small fragments. For several weeks following treatment, those small fragments are passed out of the body in the urine.
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