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Last Updated on October 31, 2025 by
Extracorporeal Shock Wave Lithotripsy (ESWL) is a non-invasive lithotripsy treatment. It uses shock waves to break kidney stones into small pieces, which can then be easily passed out of the body. However, certain medical conditions or situations can make lithotripsy risky or ineffective. Not everyone with kidney stones is a good fit for lithotripsy. For example, pregnant women, people with untreated bleeding disorders, or those taking certain medications face risks. In addition, individuals with an abdominal aortic aneurysm, severe untreated hypertension, or active urinary tract infections are generally not good candidates.
At our institution, we carefully check each patient’s condition. We then decide the best treatment plan for them. By knowing what doesn’t work, we can give personalized care that fits each patient’s needs.
The success of lithotripsy depends on choosing the right patients and knowing the procedure well. Lithotripsy, or shock wave lithotripsy (SWL), is a non-invasive treatment. It breaks down kidney stones into smaller pieces that can pass out of the body.
Shock wave lithotripsy is a groundbreaking treatment for kidney stones. It uses high-energy shock waves to fragment stones, avoiding the need for surgery. “Lithotripsy has become a cornerstone in the management of kidney stones,” say urology experts.
During lithotripsy, patients lie on a special table. Shock waves are then directed at the stone using imaging. The shock waves break the stone into smaller pieces, which can then pass in the urine. The procedure is done under sedation or anesthesia to reduce pain.
Proper patient screening is vital for lithotripsy success. We evaluate patients to see if lithotripsy is right for them. We look at stone size, location, and patient health for the best results. As medical professionals say, “careful patient selection is key to the effectiveness and safety of lithotripsy.”
By understanding lithotripsy and choosing patients wisely, we can treat kidney stones effectively and safely.
Lithotripsy is not safe during pregnancy because of the risks it poses. It is not recommended for lithotripsy for kidney stones due to the dangers for both the mother and the baby.
Pregnant women face serious risks with lithotripsy. These include miscarriage and placental displacement. The shock waves could harm the pregnancy, causing severe problems.
A study on PubMed Central shows lithotripsy is not safe during pregnancy. It points out the need for safer treatments.
The shock waves from the extracorporeal shockwave therapy can harm the fetus. This is a big concern. It’s why lithotripsy is not used during pregnancy.
For pregnant women, alternative treatments are better than lithotripsy. These might include pain relief or surgery for severe cases.
Knowing what lithotripsy is and its risks helps doctors choose safer options. Pregnant women should talk to their doctors to find the best treatment.
Certain bleeding disorders and anticoagulant medications can make lithotripsy complicated. It’s important to check if a patient can have the procedure. Lithotripsy uses shock waves to break up kidney stones into smaller pieces. These pieces can then pass out of the body in the urine.
Patients with untreated bleeding disorders face a higher risk of hemorrhage during lithotripsy. The shock waves can damage blood vessels, leading to uncontrollable bleeding. Conditions such as hemophilia or von Willebrand disease increase this risk.
We evaluate the risk of bleeding in patients with bleeding disorders. We check the severity of their condition to see if lithotripsy is safe.
Anticoagulant and antiplatelet medications can also prevent lithotripsy. These drugs prevent blood clots but increase bleeding risk during the procedure. Medications like warfarin, aspirin, and clopidogrel need careful management before lithotripsy.
We advise patients on these medications to temporarily discontinue their medication before the procedure. This is to reduce bleeding risk. But we make this decision with the patient’s healthcare provider, as stopping these medications can have risks like stroke or thrombosis.
In some cases, adjusting or stopping anticoagulant or antiplatelet medication is needed before lithotripsy. We work with patients and their healthcare providers to manage these medications. Alternative treatments or adjustments to the lithotripsy procedure may be considered for patients who cannot safely stop their anticoagulant therapy.
By assessing the risks of bleeding disorders and anticoagulant medication use, we find the best treatment for each patient. For some, lithotripsy may be an option with careful management. For others, alternative treatments may be recommended.
Cardiovascular health is key when deciding if lithotripsy is right for you. Some heart conditions can make the treatment risky. So, doctors must check patients carefully before starting.
An abdominal aortic aneurysm (AAA) is a big worry. The shock waves in shock wave lithotripsy might burst an aneurysm. This could cause serious bleeding. So, people with AAA usually can’t have lithotripsy.
Severe, untreated high blood pressure is also a no-go for lithotripsy. It can lead to bleeding around the kidney. Keeping blood pressure under control is important before the treatment.
People with pacemakers or other implants need extra care. The shock waves might mess with these devices, though it’s rare. It’s important to tell doctors about any implants before lithotripsy for nephrolithiasis, ESWL.
We look closely at each patient’s heart health for lithotripsy. If it’s not safe, we find other ways to treat kidney stones. This way, we aim for the best results.
Having infections or certain body shapes can make lithotripsy risky. When thinking about lithotripsy for kidney stones, it’s key to check the patient’s health. This includes looking for infections or body shapes that might make the treatment unsafe or less effective.
Having an active or untreated urinary tract infection (UTI) is a big no-no for extracorporeal shockwave lithotripsy (ESWL). Doing lithotripsy on someone with an untreated UTI can cause serious problems. These include spreading the infection and leading to sepsis.
Infected stones are a big risk for the ESWL procedure. Bacteria in the stone can get into the blood during the procedure, causing sepsis.
We carefully check patients for infected stones. Sometimes, we choose other treatments first to deal with the infection before lithotripsy.
Distal ureteral obstruction can make lithotripsy for kidney stones harder. Obstructions can stop stone fragments from moving after treatment, causing more problems.
Anatomical issues can make extracorporeal shockwave lithotripsy less effective. Problems like severe skeletal deformities or certain bowel issues can make it hard to hit the stone right.
We use top-notch imaging to check the patient’s body shape and plan the best treatment. If the body shape is too tricky, we might choose a different treatment.
We’ve talked about why some people can’t have lithotripsy. This treatment uses shock waves to break up kidney stones. For those who can’t have it, there are other ways to treat kidney stones.
Knowing what lithotripsy is and its limits helps find the best treatment. If lithotripsy isn’t an option, other methods like ureteroscopy or percutaneous nephrolithotomy might be suggested. These options can manage kidney stones safely and effectively.
Lithotripsy is a treatment for kidney stones, but it’s not for everyone. If you have certain health issues or body shapes, there are other treatments. Our medical team helps choose the best treatment for each patient’s needs.
Lithotripsy is a non-invasive procedure. It uses shock waves to break down kidney stones. These stones are then passed out of the body easily.
Choosing the right patients for lithotripsy is key. It ensures the treatment is safe and effective. Some conditions make lithotripsy risky, so other treatments might be better.
No, pregnant women should not have lithotripsy. It could harm the fetus and the mother. Other treatments are safer during pregnancy.
Risks include miscarriage and placental issues. Shock waves could also harm the fetus.
People with bleeding disorders or on certain medications face bleeding risks. They might need special care or another treatment.
Conditions like abdominal aortic aneurysm and severe hypertension are risky. Other treatments might be safer.
No, urinary tract infections are a no-go for lithotripsy. They increase the risk of serious complications like sepsis.
When lithotripsy is not an option, surgery or other minimally invasive methods are considered. The best choice depends on the individual’s health.
ESWL is another name for shock wave lithotripsy (SWL). It’s a non-invasive procedure for treating kidney stones.
Lithotripsy breaks down stones with shock waves. This makes them small enough to pass out of the body. It relieves symptoms and prevents further problems.
Zeng, G., & Zhou, F. (2018). Indications and contraindications for shock wave lithotripsy and how to improve outcomes. PMC (National Institutes of Health). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6197584/
