Extracorporeal shock wave lithotripsy

James Hayes and Dr Henry Knipe et al.

Extracorporeal shock wave lithotripsy (ESWL) is a common non-invasive treatment for urolithiasis, and less commonly for pancreatic or salivary ductal stones 4. It is less successful in obese patients and with stones >2 cm. Children respond equally well or better to ESWL than adults 5.

The principle of extracorporeal shock wave lithotripsy is that focused shock waves cause stone fragmentation. Repetition of this process eventually leads to pulverization of the calculi. Radiologically these can be visualized during the treatment with either fluoroscopy or ultrasound imaging. 



  • steinstrasse: incomplete fragmentation that results in a pile-up of stone fragments that obstruct the ureter
  • renal hemorrhage is rare (<1%)
  • hematuria (adult) - is common in ESWL and is considered more of a side effect from the shock waves than a complication

Article information

rID: 43461
Synonyms or Alternate Spellings:
  • Extracorporeal shock wave lithotripsy (ESWL)
  • Shock wave lithotripsy (SWL)

ADVERTISEMENT: Supporters see fewer/no ads

Cases and figures

  • Case 1: post ESWL calculus fragmentation
    Drag here to reorder.
  • Case 2: post ESWL renal hemorrhage
    Drag here to reorder.
  • Case 3: post ESWL subcapsular hematoma
    Drag here to reorder.
  • Case 4: shock wave lithotripsy-induced renal injury
    Drag here to reorder.
  • Case 5: steinstrasse
    Drag here to reorder.
  • Updating… Please wait.

     Unable to process the form. Check for errors and try again.

     Thank you for updating your details.