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Renal complications of extracorporeal shock wave lithotripsy

Gary C Curhan, MD, ScD
Glenn M Preminger, MD
Eric N Taylor, MD, MSc
Section Editor
Stanley Goldfarb, MD
Deputy Editor
Albert Q Lam, MD


Extracorporeal shock wave lithotripsy (ESWL) is widely used in the treatment of symptomatic renal and ureteral stones [1,2], but it is not indicated for asymptomatic small stones. It is most effective for stones in the renal pelvis and upper ureter, and it is less effective for larger stones (>1.5 cm), stones of harder composition (cystine, calcium oxalate monohydrate), and stones in complex renal or ureteral locations (lower pole calyx or middle or lower ureter) [3].

Although ESWL is highly effective in appropriately selected patients, a number of urinary tract complications can occur [2]. The renal complications of ESWL will be reviewed here. The role of ESWL and other modalities in the treatment of nephrolithiasis are discussed separately. (See "Options in the management of renal and ureteral stones in adults", section on 'Shock wave lithotripsy' and "Management of ureteral calculi", section on 'Shock wave lithotripsy'.)


There are four potential renal and urinary tract complications of extracorporeal shock wave lithotripsy (ESWL):

Incomplete stone fragmentation, which can lead to urinary tract obstruction

Renal parenchymal injury

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Literature review current through: Nov 2017. | This topic last updated: Oct 18, 2017.
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