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-
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
ξ Eat a light breakfast and lunch.
ξ Drink only clear liquids after lunch until
midnight. There is no limit on the
o Juice without
o Hard candy
o Boost Breeze®
o Clear Jell-O®
(no fruit in it)
o Carbonated drinks
or clear sodas
o Weak coffee or
tea, no creamers.
Sugar or sugar
substitute is okay.
o No alcohol
o No dairy products
ξ At 2:00 pm, drink 10 oz magnesium
citrate. Be sure to follow it with 8 oz. of
ξ Be sure to drink this where you will be
near a bathroom. It will cause you to
have several bowel movements.
ξ 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
Home Care after Your ESWL
1. Start slowly with clear liquids. You may
add solid food to your diet as you are
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
ξ Burning when passing urine
ξ Blood tinged urine
ξ Small blood clots in your urine
ξ Passing urine more often than
ξ Redness at the site of the treatment
(on your side or back)
ξ Back or abdominal pain as the stone
fragments pass through the urine
ξ For mild pain, you may take
acetaminophen (Tylenol ). Do not
exceed 4 grams, or 4,000 mg/day.
ξ 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
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
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
When to Call your Doctor
ξ Temperature over 100.4 θ F by mouth,
for 2 readings taken 4 hours apart
ξ Pain not controlled by pain pills
ξ Nausea or vomiting for more than 24
ξ Low urine output
ξ Problems passing urine
ξ Severe burning when passing urine
ξ 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:
Your medical record number is
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 10/2016 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5371