Using shockwaves to treat kidney stones

Using shockwaves to treat kidney stones

What are kidney stones

Kidney stones are hard deposits formed when salts and minerals in the urine bind together. They can occur in one or both kidneys and are most common between the ages of 30 and 60. Stones vary in size, from tiny grains to larger pieces that can block the flow of urine.

What are the symptoms of kidney stones

Small stones may pass without causing any symptoms. Larger stones can move into the ureter and may lead to:

• Severe pain in the abdomen, back or groin
• Blood in the urine
• Nausea or vomiting
• Urinary frequency or pain
• Urinary tract infections

Kidney stones affect around 3 in 20 men and up to 2 in 20 women. When a stone blocks the urinary system, pressure builds up in the kidney, leading to significant discomfort and sometimes infection.

What is lithotripsy (ESWL) and how does it work?

Extracorporeal Shock Wave Lithotripsy (ESWL) uses focused shockwaves to break the stone into tiny fragments that can pass naturally. Ultrasound or X-ray imaging guides the waves directly onto the stone.

Most people need up to three sessions depending on the stone’s size and density. Each treatment lasts around 30 to 45 minutes.

Is lithotripsy for kidney stones painful?

Most people find lithotripsy only mildly uncomfortable, and the sensation is often compared to an elastic band flicking the skin. Pain relief is available if needed, and the team will adjust the treatment to keep you as comfortable as possible.

Who is ESWL suitable for?

Lithotripsy is generally recommended for people with stones in the kidney or ureter that are unlikely to pass on their own. It is most effective for stones that are:

• Small to medium in size
• Visible on X-ray or ultrasound
• Not too dense or hard
• Located where shockwaves can be accurately targeted

Your consultant will assess the size, position and composition of the stone to decide if ESWL is the right choice. It may not be suitable if the stone is very large or too hard to treat. Some health conditions may also make alternative treatments more appropriate.

What to expect on the day

On the day, you will be welcomed by the nursing team and taken through a short checklist. You may have an abdominal X-ray before treatment. After changing into a gown, you will receive pre-medication, usually a simple pain-relieving suppository.

In the treatment room, the radiographer will help you to maintain a comfortable position and apply gel to the skin. You will hear a clicking sound as the shockwaves begin. Staying still helps keep the targeting precise.

After your session, you will rest in the recovery area and be encouraged to drink plenty of fluids. Before leaving, you will receive aftercare advice and details of your follow up appointment.

Aftercare and recovery

After the procedure, you may have mild redness over the treatment area and a small amount of blood in the urine for a couple of days. It is advised that patients rest for the first day and then return to normal activities if they feel well. It is recommended to drink at least two litres of fluid daily to help flush out any fragments.

Take prescribed pain relief if needed but avoid aspirin or anti-inflammatory medication unless advised. If you develop fever, chills or feel unwell, contact your GP or the Urology team straight away, as this may indicate infection.

Larger stones may require additional sessions. Some patients notice small stone particles in their urine, although many fragments are too fine to see.

If you have symptoms of a kidney stone or want to explore treatment options, our Urology specialists are here to support you.

What other treatment options are available at HJE if ESWL is not suitable?

If Extracorporeal Shock Wave Lithotripsy (ESWL) is not advised for your stone, we also offer the following alternative treatments:

• Laser Kidney Stone Removal (laser lithotripsy) – A minimally invasive procedure using a fine laser via a ureteroscope to fragment the stone.
• Percutaneous Nephrolithotomy (PCNL) – A minimally invasive inpatient procedure under general anaesthetic for large kidney stones which cannot be treated with less invasive methods.

Your consultant will assess the size, location and composition of the stone, and your medical history, to guide you to the most appropriate treatment.

Booking an appointment

If you are experiencing symptoms of a kidney stone and would like an assessment, you can book a consultation at our leading London Urology Clinic by calling our friendly team on 020 7806 4060.

Our team will arrange the most suitable appointment and advise you on next steps.

Content provided by Kevin Jones, London Lithotripter Centre.