Shock wave therapy (extracorporeal shock wave lithotripsy, ESWL) for kidney and ureteral stones

ESWL can be performed on kidney and ureteral stones without anaesthesia. It is therefore suitable, for example, as a method for patients with a high anaesthetic risk. However, ESWL also has some limitations. Several sessions are often required, which makes the treatment lengthy. In addition, small residual fragments often remain in the kidney, which can lead to the rapid formation of new stones. Residual fragments in the ureter can result in painful urinary retention, which requires surgical stone removal. ESWL cannot be performed on certain types of stone because they do not respond to shock waves.
ESWL should not be performed while taking blood thinners, as the shock waves can cause bleeding in the kidney.

In ESWL, the shock waves are transmitted via a plastic cushion that is "docked" onto the skin. The stone is then located and focused either by X-ray or ultrasound. Several thousand shock waves are then applied. The treatment is carried out after painkillers have been administered intravenously, as ESWL can be somewhat unpleasant. The doctor then adjusts the strength of the waves to a tolerable level.