Shockwave lithotripsy (SWL) is a non-invasive procedure used to treat kidney and ureteral stones by breaking them into smaller fragments using targeted acoustic shockwaves. These fragments can then pass naturally through the urinary tract. SWL is one of the most commonly used treatments for stones that are too large to pass on their own but are still small enough to be treated without surgery.
When Is Shockwave Lithotripsy Recommended?
SWL is typically used for kidney or ureteral stones that are:
- Less than 2 centimeters in diameter
- Located in the kidney or upper ureter
- Composed of materials that respond well to shockwaves, such as calcium oxalate
- Causing symptoms like pain, blood in the urine, or obstruction of urinary flow
This treatment is not ideal for very large stones, certain types of hard stones, or stones located in the lower ureter. It may also be less effective in patients with obesity or anatomical abnormalities that interfere with imaging or shockwave targeting.
How the Procedure Works
Shockwave lithotripsy is usually performed on an outpatient basis. The patient lies on a water-filled cushion or soft treatment table. Using X-ray or ultrasound guidance, the urologist precisely locates the stone. Once the stone is targeted, a lithotripter sends high-energy shockwaves through the body to the stone.
- The procedure usually takes 45 to 60 minutes
- Thousands of shockwaves are delivered to gradually break the stone into tiny fragments
- A stent may be placed beforehand to help keep the ureter open and ensure passage of the fragments
- Sedation or anesthesia is typically used for comfort during the procedure
Benefits of Shockwave Lithotripsy
- Minimally Invasive: No incisions or surgical instruments are used
- Fast Recovery: Most patients return to normal activities within a few days
- Low Risk of Complications: Fewer risks compared to surgical options
- Effective for Select Stones: Especially for those located in the kidney or upper ureter
Some patients may require multiple treatments if fragments remain or if the initial stone does not fully break apart. Occasionally, large fragments may cause temporary ureteral blockage, requiring additional intervention.
Next Steps
If you are experiencing pain, urinary symptoms, or have been diagnosed with a kidney or ureteral stone, your urologist can determine if shockwave lithotripsy is right for you. Imaging and stone analysis will help guide the best treatment plan for safe and effective stone removal.