Shockwave therapy (Extracorporeal shock wave lithotripsy, ESWL)

ESWL can be performed without anaesthesia for kidney and ureteral stones. Therefore, it is suitable as a method for patients, for example, who have a high anaesthetic risk. However, ESWL has some limitations. For example, several sessions are necessary, making treatment lengthy. In addition, small residual debris often remains in the kidney, which can lead to rapid formation of new stones. Residual debris in the ureter can result in painful urinary retention, making surgical stone removal necessary. ESWL cannot be performed on certain types of stones as they do not respond to shockwaves.

ESWL should not be performed on a patient taking blood thinners, as the shockwave can cause a kidney haemorrhage.

In ESWL, shockwaves are transmitted via a plastic pad that is “docked” to the skin. The stone is then located and focused on using either X-ray or ultrasound. Several thousand shockwaves are then applied to the area. The treatment is carried out after the administration of painkillers through a vein, as ESWL can be somewhat uncomfortable. The strength of the waves is then adjusted to a tolerable level by the doctor.