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Shock Wave Lithotripsy

at Cedars-Sinai Marina del Rey Hospital

Cedars-Sinai Marina del Rey Hospital provides you with the safest procedure for eliminating the kidney stones that cause you health-related issues. Thanks to the state-of-the-art equipment and procedures found at our health center, the highly skilled urologists from Cedars-Sinai Marina del Rey Hospital are able to perform this non-surgical procedure for you to resume your usual activities in the shortest time possible.

Having one of the highest success rates in achieving kidney stone removal, the shock wave lithotripsy is the procedure most likely to restore your health and well-being.

Extracorporeal Shock Wave Lithotripsy (ESWL) is a totally non-invasive treatment for patients with kidney stone disease. The innovative procedure uses focused ultrasonic energy or shock waves to target stones that cannot be eliminated naturally. The shock waves travel through the skin and tissue, reach the targeted stones and break them into sand-like fragments that will more easily pass through the urinary tract. Complete elimination of stones can generally be achieved during the first couple of months following the procedure. However, for larger stones, the ESWL treatment may need to be repeated.

ESWL is the treatment of choice for patients with certain types of kidney stones, localized in certain areas of the urinary system, causing pain or blockage of the urine flow. The size of the stones is also important, as ESWL is used to fragment stones larger than 4 mm, but usually smaller than 2 cm in diameter.

Although it is an outpatient, non-surgical procedure, ESWL is performed under sedation or general anesthesia and lasts approximately one hour, depending on the size and number of the kidney stones.

It usually takes a couple of hours in the recovery before you are ready to go back home.

Here are the steps to be taken for the procedure:

  • You will check into the hospital and change into a medical gown
  • You will be brought to a surgical suite where you will lie on a water-filled cushion
  • You will be placed under general or local anesthesia
  • The surgeon will use X-rays or ultrasound to establish the exact position of the stones
  • Then the surgeon will use a lithotripter to generate up to 3000 shock waves that will vibrate and eventually pulverize the targeted stones
  • A stent (a tiny tube) may be placed inside the ureter to allow larger fragments to pass through the urine stream without blocking the urinary tract or causing pain

Extracorporeal Shock Wave Lithotripsy is a safe and effective non-surgical procedure, requiring minimal recovery time. It has a 50-90% success rate, so usually, stones are removed completely, but in some cases further, ESWL or other non-invasive treatments may be needed to clear all the stones.

A specialist will evaluate your condition and decide whether ESWL is the right treatment for you. A different medical treatment may be recommended in any of the following situations:

  • Pregnancy, as the X-rays used to locate the stones may expose the baby to radiation
  • Patients with bleeding disorders
  • Patients with abnormal kidney structure and/or function, as the abnormalities may prevent clear X-ray view and accurate localization of the stones
  • Patients with active kidney infections or other types of urinary tract infections and kidney cancer
  • The position of the stones makes it unlikely for them to pass through the urinary tract
  • The stone composition is likely to resist the force of the shock waves (the density is predictable with CT-scanning by measuring the radio-opacity of the stones)
  • Patients with arrhythmia

The risks involved in ESWL are minor and severe complications are unlikely. Besides the risks that are generally associated with anesthesia, some of the specific potential risks are:

  • Bruising and discomfort in the abdominal area due to the impact of the shock waves
  • Pain and discomfort caused by the passing of the stone fragments through the urinary tract
  • Blood in the urine (may last for a few days after the procedure especially if a stent has been used)
  • Small risk of renal injury
  • Infection
  • Fever
  • Ureteral obstruction (when migrating pieces of stone get stuck in the ureter and inhibit the normal flow of urine)

The recovery time after the ESWL procedure is short. You may be prescribed analgesics as the pieces of stone that start migrating through the urinary tract may cause discomfort and pain. As the treatment is non-invasive, you may resume your usual activities in one or two days following the ESWL procedure.