Extracorporeal Shock Wave Lithotripsy (ESWL)

Extracorporeal Shock Wave Lithotripsy (ESWL) is a procedure used to shatter simple stones in the kidney or upper urinary tract. Shock waves are passed through the body until they strike the dense stones. Pulses of shock waves pulverize the stones, which are then more easily passed through the ureter and out of the body in the urine.

What to expect after surgery?

You may pass small particles of stones post ESWL it is important to drink plenty of fluids to help pass any additional pieces of stones.

  • You may have blood in your urine for the first 2 to 3 days.
  • You may be asked to strain your urine for stones. The stones will be evaluated to distinguish what type
  • of stone. This will help in preventing further stones.
  • You may have a ureteral stent placed that will help urine pass and keep the ureter open.
  • There may be increased burning sensation with urination this should pass after the first week.
  • Avoid strenuous activity, exercise or work for 24 hours following the procedure.
  • Walking will help in passing the stone fragments.
  • Your bowels may be sluggish after surgery and pain medication can increase constipation. Follow the postoperative bowel program handout.
  • You can use a heating pad to help with muscle soreness.
  • You may have a bruise on your flank postoperatively.
  • You may shower when you go home.
  • Use your pain medication as directed if needed, if pain is mild you can use acetaminophen.

Activity and postoperative restrictions

  • Walking and light exercise is important in prevent Deep Vein Thrombosis.
  • You should expect to return to work in 1 week or less.
  • You should reduce your activity levels for the first 2 to 3 days while healing
  • Do not drive while taking narcotics.


You may return to your normal diet. You may want to avoid acidic foods and drinks that may cause burning with urination. Drinks with caffeine may cause frequency and irritation to your bladder. If you’re not on a sugar or salt restriction diet, drink 8 to 10 glasses of water and Gatorade daily to avoid constipation and to prevent possible urinary tract infections.


  • You should resume your pre-surgery medication unless told otherwise.
  • Do not take any aspirin products for the first two weeks.
  • If you are taking Warfrin or Plavix this should be followed by your primary care provider
  • postoperatively. They will discuss with you when to resume medication and dosing recommendations.
  • If you are taking pain medication or iron supplements you should also be taking a stool softener to keep the stool soft.
  • If your pain is mild you can stop taking the pain medication and switch to acetaminophen.

Medications to have at home before surgery

  • Stool Softener
  • Fiber
  • Milk of Magnesia
  • Acetaminophen

If you experience any of these symptoms please call Urology Northwest 425-275-5555:

  • Fever over 101 Fahrenheit by mouth
  • Pain not relieved by medication
  • Rash, itching after taking pain medication
  • Continued nausea and vomiting
  • Inability to urinate
  • Chills
  • Swelling of the calf, ankle or foot
  • Increased warmth of the leg
  • Pain in the leg
  • Bluish discoloration of the skin or leg

Postoperative follow up

You will need a follow-up appointment to monitor your progress in 2 to 3 weeks post operatively. You will be called for a postoperative follow up 1 to 2 days after surgery. You can make your postoperative appointment at that time or by calling and speaking to a receptionist. If you have a stent your follow-up appointment will typically be within 1 to 2 weeks after surgery.

For further stone work up talk to your provider about doing a 24 hour urine and stone panel to learn what type of stone you’re making and why. This will help in preventing further stones. Meeting with one of our Naturopaths to discuss the test results may also be beneficial in discussing what foods to avoid that may be playing a role in your production of stones.