Shock Wave Lithotripsy (ESWL): What to Expect

ESWL uses focused shock waves from outside the body to break a kidney stone into small pieces that you then pass in your urine. There is no incision.

Warning signs

Before your procedure

Take only the medicines your care team approved. If you take a blood thinner, aspirin, or a supplement and were not told what to do, call the office — do not stop anything on your own. Blood thinners matter here because ESWL can cause bruising and bleeding around the kidney.
Arrange a ride home, since you may receive sedation or anesthesia.
Follow the fasting instructions you were given.

The day of

You receive sedation or anesthesia. A machine sends shock waves through the skin to the stone, breaking it into small pieces. The treatment usually takes about 45 to 60 minutes, and you go home the same day.

The first few days

As the pieces pass, it is normal to have:

Blood in the urine for a few days
A bruise or tenderness on the skin over the treated side
Cramping or waves of flank pain as fragments move down
The need to pass small gritty pieces

Drink enough to keep your urine light yellow to help flush the fragments. Use your pain medicine as directed. Strain your urine if you were asked to, and save any pieces for testing.

The first few weeks

Passing fragments can go on for days to a few weeks. Your care team may order an imaging test later to check that the stone has cleared.

When to call your care team

Call the office number on your discharge paperwork right away, or seek emergency care, if you have any of these:

Fever of 100.4°F (38°C) or higher, or shaking chills
Severe pain that your medicine does not control
You cannot urinate at all
Vomiting that will not stop
Heavy bleeding or large clots in the urine

If you have chest pain, trouble breathing, fainting, or another life-threatening emergency, call 911.

Warning signs