Extracorporeal shock wave lithotripsy (ESWL)

Extracorporeal shock wave lithotripsy (ESWL) is a nonsurgical way to treat kidney stones and stones in the ureter or in bile or pancreatic ducts. Instead of making an incision, a machine called a lithotripter sends high energy pressure waves through the body. These waves target the stones and break them into tiny fragments. After treatment, these stone pieces usually pass in the urine over days to weeks. This noninvasive treatment can help avoid surgery in many cases.

Penn Medicine’s urinary stones care specialists include urologists with deep experience in ESWL and other lithotripsy treatments. We use detailed imaging and carefully adjusted shock wave settings to target stones with precision so we can support better outcomes while limiting impact on nearby tissue.

While shock wave therapy for kidney stones is very common, it isn’t the right choice for every person or every stone. Your provider will review your health history and the type of stone you have before recommending this lithotripsy procedure.

You may be a good candidate if your stones are:

• Located in the kidney or upper part of the ureter
• Small enough to be seen clearly on an X-ray
• Causing pain or blocking the flow of urine

Extracorporeal shock wave lithotripsy is usually done as an outpatient procedure, so you can go home the same day. You’ll receive medication to help you stay comfortable and pain free. During the procedure, you lie on a padded table while imaging is used to locate the stone.

Once the stone is targeted, a series of shock waves is delivered through the body. You may hear clicking sounds. Some people feel a light tapping sensation. The care team adjusts the strength and timing of the waves to break the stone effectively. The procedure often takes about one hour, depending on the number and size of the stones.

After the procedure, you may spend a short time in a recovery room before going home. Most people can return to their normal life within a few days. While your body heals, you’ll pass stone fragments in your urine over several days or weeks. You can expect to see some blood in your urine, which is normal. As the tiny stone fragments move out of your body, you might feel some dull aches or soreness in your side. Drinking plenty of water is the best way to help these pieces pass quickly.

Extracorporeal shock wave lithotripsy is widely used and considered safe, but like any treatment, it carries some risks. Most lithotripsy side effects are temporary and improve as your body heals.

Common side effects may include:

• Blood in the urine for a short time
• Bruising or soreness near the treatment area
• Pain as stone fragments pass

Care for kidney stones isn’t one size fits all. At Penn Medicine, experienced specialists use advanced imaging to guide each step of the ESWL procedure and pinpoint stones with precision. You’ll have access to the latest lithotripsy technology, allowing care teams to tailor treatment to your specific needs.

This approach includes:

• Using detailed imaging to precisely locate and target stones 
• Adjusting shock wave settings to improve effectiveness and comfort 
• Offering a full range of treatments if additional care is needed