Your specialist has recommended that you have a lithotripsy to treat kidney stones. This factsheet provides some standard information and advice about the procedure. However, you should always follow the instructions of your own specialist.
If you have any unanswered questions or concerns, please do not hesitate to ask your specialist or nurse for more information. It is natural to feel anxious, but knowing what to expect can often help.
What is lithotripsy?
Ultrasound shockwaves are used to break the kidney stones into tiny fragments, which can then be flushed out of the body in the urine. The procedure is often referred to as extracorporeal shockwave lithotripsy (ESWL). No surgery is involved.
This treatment is routinely performed as an outpatient or day case, without the need for anaesthetic or an overnight stay.
Before you come to hospital
You will need to go without food for four hours before your appointment, and have nothing to drink for two hours before you arrive.
You will be given a consent form to sign. By doing this, you confirm that you understand what the procedure involves, including the benefits and risks, and give your permission for it to go ahead.
Please refer to further information below regarding the possible side-effects and complications of this procedure. You need to know about these in order to give your informed consent.
About the procedure
Lithotripsy is done on a special treatment table called a lithotripter couch. The treatment usually lasts for about 30 to 40 minutes. If you have several stones in the same kidney they may all be treated, but only one kidney is treated at a time.
You will not need to have any anaesthetic. Although the shockwaves themselves do not hurt, most people feel an unusual and uncomfortable sensation as the stone is broken up. You will be given pain relief to make the procedure more comfortable. You may also be given some medication to prevent nausea.
What to expect
In a private room or cubicle, you will be asked to remove your clothing and put on a hospital gown. You should also remove any jewellery, which will be kept safe for you during the procedure.
You will lie on your back on the lithotripter couch and X-rays or ultrasound will be used to pinpoint the exact position of the kidney stone. Once it has been located, some gel will be smeared on your skin to enable good contact with the head of the lithotripter machine, which will focus the shock waves precisely onto the stone to break it up.
The machine will make a clicking noise as it works but you will probably not feel very much at all to begin with. The intensity of the shockwaves will be increased gradually, as and when you feel ready. You will be able to talk to your specialist at all times.
After your treatment, you may rest in your room or day care bed for an hour or two. You will be asked to empty your bladder before you leave.
Before you go home, a nurse will make arrangements for you to have a further X-ray and a follow-up appointment at the outpatient clinic.
You may receive painkillers that will affect your ability to drive, so you will need to arrange for someone to take you home. If you have received a strong painkiller, it may temporarily affect your co-ordination and reasoning skills, so you should avoid drinking alcohol, operating machinery or signing legal documents for 24 hours afterwards.
You will be given some mild painkillers to take home with you. Its sensible to take it easy for the rest of the day and if possible arrange to have the following day off work.
You should drink plenty of fluids one or two glasses of water per hour in addition to any other beverages) for 48 hours after your treatment. It is quite normal to have small fragments of the broken stone a little blood in your urine during this time.
Gentle exercise may help to move the stone fragments out of your system. For a few days after your treatment, lie on your back, bend your legs at your hips and make a pedalling action, as if riding a bicycle.
You should contact the hospital or your doctor:
- if you feel unwell or have a lot of pain after your treatment
- if you develop a high temperature
- if your urine becomes smelly
What are the risks?
Lithotripsy is generally a safe treatment. For most people, the benefits of having this non-surgical treatment for kidney stones are much greater than any disadvantages. However, like all invasive medical procedures, there are some risks. These can be divided into the risk of side-effects and the risk of complications.
These are the unwanted, but usually mild and temporary, effects of a successful procedure. After lithotripsy, you may have some pain and you will be given some mild painkillers to relive this. You may also have a small amount of blood in your urine and pass some tiny fragments of the broken stones for 24-48 hours afterwards.
The success of the treatment will depend on the density, size and position of the stone. Your specialist will be experienced at performing this type of procedure, but, even so, some ithotripsies are not successfully completed and may need to be repeated.
Other complications are uncommon, but it is possible to develop a urinary tract infection afterwards, requiring treatment with antibiotics.
The chance of complications depends on the exact type of procedure you are having and other factors such as your general health. You should ask your doctor to explain how these risks apply to you.
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
University of Maryland Medicine
National Institute of Diabetes and Digestive and Kidney Diseases