Shock Wave Treatment

Shock Wave Treatment

Shock Wave Lithotripsy (ESWL)In the United States, Extracorporeal Shock Wave Lithotripsy (ESWL) is the most common treatment for kidney stones. This nonsurgical technology uses high energy shock waves that travel at supersonic speed to target and pulverize kidney stones. The stone fragments then are excreted in the patient’s urine.

ESWL is usually used to treat stones smaller than 2 cm in diameter. In some circumstances, it can be used for larger ones. In large stones, however, the large amount of stone debris can obstruct the ureter (the tube connecting the kidney to the bladder). Dr. Pugach will discuss if ESWL is an appropriate treatment for your kidney stones after a comprehensive medical examination and diagnostic testing.


Original lithotripsy machines were developed by a German aerospace manufacturer. The technology was an outgrowth of research into why supersonic airplanes developed concentric cracks in their windscreens. By applying supersonic shock waves to stones, small cracks develop that progress to stone fragmentation.

The original lithotripsy devices required that patients be immersed in a huge stainless steel tub where the shock waves were sent through the water. New technology sends shock waves through padded cushions on a portable table, so patients do not have to be immersed in water. You will feel no pain during the procedure because general anesthesia is administered. Afterwards, patients typically experience mild to moderate back pain for a few days that is relieved with oral pain medication.

ESWL is an outpatient procedure. After your procedure, we want you to drink extra fluids and sleep on your side to help flush out the stone pieces. We’ll also give you a urine strainer to capture the stone pieces for analysis.

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