Extracorporeal shock wave lithotripsy (ESWL) is a non-invasive treatment of kidney stones. There are no incisions. It uses x-ray to guide shockwaves at kidney or ureteral stones stone from outside your body to crush stone. 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.
One week before the ESWL, do not take aspirin or medicines that contain aspirin, ibuprofen (Motrin®, Nuprin®, or Advil®), NSAIDs, vitamin E, or “blood-thinning” medicines.
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 fridge. It is easier to drink chilled.
The Day Before ESWL
Eat a light breakfast and lunch.
Drink only clear liquids after lunch until midnight. There is no limit on the amount. Do not drink alcohol or dairy products.
At 2:00 pm, drink one bottle of magnesium citrate. Be sure to follow it with 8 oz. of water.
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.
Juice without pulp (apple cranberry, grape)
Carbonated drinks or clear sodas
Weak coffee or tea, no creamers (sugar or sugar substitute is okay)
Home Care After ESWL
Start slowly with clear liquids. You may add solid food to your diet as you are able.
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.
Do not drink alcohol for 48 hours.
What to Expect After 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 take more than 4g, or 4,000 mg per 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’ should 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.
Walk as much as you can. This will help to pass the sand-like fragments.
Do not lift more than 10 pounds for 24 hours. If you have 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.
You may shower or bathe as you like.
No sex for 24 hours. If you have a stent in place, sex may cause pain or blood in your urine. If this happens, do not have sex until your urine is clear and you have no pain.
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
Fever 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
Who to Call
After hours call the paging operator at:
608-262-0486. Ask for the urology doctor on call. Leave your name and number with the area code. The doctor will call you back.
The toll-free number is:
Your medical record number is: __________________________________
If you are a patient receiving care at UnityPoint – Meriter, Swedish American or a health system outside of UW Health, please use the phone numbers provided in your discharge instructions for any questions or concerns.