How does shock wave therapy treat my kidney stones?

Shock wave therapy, also called extracorporeal shock wave lithotripsy (ESWL), treats kidney stones using high-energy shock waves, without the need for surgery. Stones in the kidney or ureters (the tubes going from the kidneys to the bladder) are broken into "stone dust" or fragments that are small enough to pass in urine. lf large pieces remain, another treatment can be performed. About 1,000 to 2,000 shock waves are needed to crush the stones. 
Extracorporeal shock wave lithotripsy (ESWL) works by firing an acoustic shockwave through the body focused at a pinpoint target…the stone. The shockwaves are targeted to shatter the stone, then the small pieces of the stone pass more easily. It’s very successful at breaking up certain types of stone. 

The ESWL treatment is a maximum 3,000 shockwaves at a time. Usually it requires general anesthesia for pain, but some machines can be used with the patient awake. There are better results with general anesthesia. ESWL is an outpatient procedure that lasts about an hour.

ESWL is noninvasive, but the downside is that it doesn’t have a perfect success rate.
One variable determining success rates is where the stone is located. The shockwave only breaks the stone; it does not remove it. So if the stone’s at the bottom of the kidney, it may break but not get over the hurdle and down the ureter. Stones higher in the kidney, just by gravity alone, have a better success rate.

Success also depends on the type of the stone; certain stones, such as calcium oxalate monohydrate, don’t break -- they are diamond-hard and resistant to shockwaves.

Stone size is another factor: The bigger the stone, the smaller the success rate. Even if you break a large stone, you still have to pass the pieces, and with too many pieces, there can be a blockage. Obesity is another factor, as the shockwaves have to travel a greater distance through the body, which lowers the focus of energy.

Shock wave therapy, or ESWL, uses shock waves to break up your kidney stones into smaller pieces that can then pass through your body. You may sit in a large tub of water or lie on a table to receive shock wave treatments. Shock wave therapy has temporary side effects that include abdominal bruising, bleeding, and moderate pain. You may be sedated during treatment.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.