Eswl leaflet

What is it?
This is a treatment given in outpatients using shockwaves to shatter kidney
stones into small pieces, so that they can be passed in the urine. This
treatment is very effective and works 70% of the time though often more
than one treatment is required. Frequently you will be required to have an X-
ray after your treatment to see whether the stone has shattered. The amount
of stone remaining determines whether further treatments are required.
Where do I go?
You will be offered an appointment at the lithotripsy suite located in Elmstead
Day Hospital, Colchester Hospital University Foundation Trust. You may be
required to go to the X-ray department to have an X-ray prior to your
What will happen?
You will be seen by a Nurse and a Doctor who will prepare you for treatment.
You will be asked to sign a consent form and receive a selection of painkillers
prior to your treatment and to take at home afterwards. In the treatment
room the stone will be localised using X-rays or ultrasound and you will be
asked to move into a suitable position so that the stone can be focused upon.
Once the stone has been localised the treatment begins with a flicking
sensation on the skin. Patients usually get used to this rather quickly. The
rate of the shockwaves is increased over a period of time; usually 3,000
shocks are given over 30 or 45 minutes. The strength of shockwaves and
their frequency will be altered depending on the size and position of the stone.
What happens after the treatment?
You may return home with additional painkillers. A follow up appointment will
be made. Often your case will be discussed after you have had an X-ray in
our stone meeting and we will write to you with the results.
The treatment breaks the stones into little pieces which you can usually pass. Drinking plenty of fluids will help.
What are the side effects?
Passing blood in the urine and discomfort caused by bruising around the
kidney can occur occasionally. Severe pain is uncommon but can result if a
segment of stone breaks off from the kidney and lodges in the tube between
the kidney and the bladder. This is a possibility in patients who do not have a
ureteric stent in place. If this occurs the pain will be severe and you will need
to attend the Accident & Emergency Unit at Colchester Hospital University
Foundation Trust.
What if I am on blood thinning tablets
You must stop Aspirin, Clopidogrel or Dipyridamole one week before your
treatment. Please discuss your treatment with a member of the urology team
well in advance if you are on Warfarin.
What if I’ve got an infection?
If you have symptoms suggestive of a urine infection you must let a member
of staff know. The treatment cannot be performed if there is a reasonable
suspicion of infection. Your treatment must be postponed to avoid dangerous
side effects.
Can I drive?
No. You will need to ensure that somebody can take you home after your
treatment as you are given strong painkillers.
Who is excluded from treatment?
Patients who are pregnant, on Warfarin, or have an abdominal aortic
aneurysm are excluded from this treatment as it can produce dangerous


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