Extracorporeal Shock Wave Lithotripsy (ESWL)
Using x-ray guidance, shockwaves are directed at the stone from outside your body to crush the kidney or ureteral stone. ESWL is a non-invasive treatment of kidney stones. There are no incisions. The shock waves pass harmlessly through your body. They hit the stone, causing it to crumble into sand-like pieces. These pieces can then pass out of your system with urine.
1. One week before the ESWL, do not take aspirin, aspirin-containing medicines, ibuprofen (Motrin®, Nuprin®, or Advil®), NSAIDs, Vitamin E, or “blood-thinning” medicines.
2. You will need to do a bowel prep the day before the ESWL. Go to your local drug store and buy one bottle of magnesium citrate 10 oz. Store it in the refrigerator. It is easier to drink chilled.
The Day before your ESWL
- Eat a light breakfast and lunch.
- Drink only clear liquids after lunch until midnight. There is no limit on the amount.
- Juice without pulp (apple, cranberry, grape)
- Hard candy
- Boost Breeze®
- Clear Jell-O® (no fruit in it)
- Carbonated drinks or clear sodas
- Weak coffee or tea, no creamers. Sugar or sugar substitute is okay.
- No alcohol
- No dairy products
- At 2:00 pm, drink 10 oz magnesium citrate. Be sure to follow it with 8 oz. of water.
- Be sure to drink this where you will be near a bathroom. It will cause you to have several bowel movements.
- In the evening, drink 1 liter of a sport-type drink (Gatorade®). It must contain electrolytes. You may have any flavor.
Do not eat or drink anything after midnight.
Home Care after Your ESWL
1. Start slowly with clear liquids. You may add solid food to your diet as you are able.
2. When you can drink fluids well, drink at least 10-12 glasses (8 ounces each) of liquid each day. The increase in fluids helps you pass the stone pieces and decreases the amount of small blood clots in your urine.
3. Do not drink alcohol for 48 hours.
What to expect after the ESWL
- Burning when passing urine
- Blood tinged urine
- Small blood clots in your urine
- Passing urine more often than normal
- Redness at the site of the treatment (on your side or back)
- Back or abdominal pain as the stone fragments pass through the urine tract
- For mild pain, you may take acetaminophen (Tylenol®). Do not exceed 4 grams, or 4,000 mg/day.
- For more intense pain, take the pain pills ordered by your doctor.
We will give you a strainer to strain your urine at home. The stone pieces or ‘sand’ will be brought in or need to be sent to your urology doctor for testing. Bring or send them in the sterile, plastic bottle you were given.
1. Walk as much as you can. This will help to pass the sand-like fragments.
2. Do not lift more than 10 pounds for 24 hours. If there is blood in your urine, do not lift until the urine is clear. Do not take aspirin, NSAIDs (ibuprofen products), or blood thinners until there is no blood in your urine.
3. You may shower or bathe as you like.
4. No sex for 24 hours. If a stent is in place, sex may cause pain or blood in your urine. If this happens, abstain until your urine is clear and there is no pain.
5. Do not drive or use heavy machines for 24 hours or while taking narcotic pain pills.
Your follow-up visit will be 2-4 weeks after your ESWL. You will have an x-ray and if you have a stent in place, it may be taken out.
When to Call your Doctor
- Temperature over 100.4° F by mouth, for 2 readings taken 4 hours apart
- Pain not controlled by pain pills
- Nausea or vomiting for more than 24 hours
- Low urine output
- Problems passing urine
- Severe burning when passing urine
- Large blood clots in the urine
(608) 263-4757 - this is a 24 hour number
Nights, weekends, and holidays: (608) 262-0486. Ask for the urology doctor on call. Leave your name and phone number with the area code. The doctor will call you back.
If you live out of the area, please call: 1-800-323-8942.
Your medical record number is __________________________________
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 02/04/2013
Copyright © 02/04/2013 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5371
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