After undergoing the required tests for Extracorporeal Shockwave Lithotripsy, the patient is then placed on a table. A water balloon, inside which the shock waves are generated, is placed in contact with the body on the side of the stone to be treated.

Using x-ray imaging, the stone is localised and focused upon. Pressure waves are then generated and focused onto the stones – approximately one every second. These pressure waves will fragment the stone. The duration taken for this again depends upon the size and the number of stones to be treated. Generally, the duration is limited to 45-50 minutes. If the stone has not cleared, repeat treatments will be administered.


The main advantage of ESWL is that open surgery is not required. Apart from minimal discomfort, there is no severe pain and therefore the requirement of anesthesia is also very minimal. There is also no hospitalization involved most of the time. As a result, the patient can get back to work the next day.

There are no known long-term complications of this procedure. Side effects such as discomfort during the procedure may be present on a few occasions. All patients will experience some amount of bleeding in the urine after treatment. Passage of the fragments down the urinary tube can cause pain, which can be managed by analgesics.

Some patients, however, may need endoscopy and stenting of the ureter to prevent persistent pain. This may require hospitalization for a day. At other times, a large load of stone powder may get blocked in the urinary tract, again requiring endoscopic intervention. A small percentage (5%) of stones do not get broken by this method and may need other modes of stone removal.

All stones definitely cannot be cleared with ESWL. The success rate with stones in the kidneys is much higher than stones lower down in the urinary tract. Smaller stones have a better success rate than larger stones (stones that are larger than 1.5cm).

Pregnant women, patients with urinary tract infection, uncontrolled diabetes or hypertension, and bleeding disorders, are not candidates for this form of treatment. Similarly, those patients whose kidneys are not functioning will also not benefit from ESWL.

After ESWL, the patient needs to come back for further evaluation. The proof that the treatment was successful is obtained by performing an ultrasound evaluation and x-rays, to confirm the passage of the stones. Sometimes, small 3-4 mm stones may be left behind, which are generally of no consequence.

Statistics indicate that 50% of all patients with urinary stones are likely to form a stone again. For this reason, certain dietary changes are prescribed for all patients with this condition. This mainly involves cutting down on non-vegetarian food and highly carbonated drinks increased dietary fiber and increased fluid/water intake.