At Children’s Health, we have our own ESWL machine in our hospital so your child will receive care from pediatric providers who specialize in treating children. For example, our pediatric anesthesiologists are experts in working with children of all sizes, from 3-pound babies to nearly grown teenagers. Other hospitals send their patients to facilities that treat adults and children.
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Extracorporeal Shock Wave Lithotripsy (ESWL) is a noninvasive treatment for kidney stones. The goal of ESWL is to shatter your child’s kidney stone into fine pieces of sand. A machine (called a lithotripter) sends a series of shock waves through your child’s skin and into the kidney to break their kidney stones into tiny pieces the size of grains of sand. Your child’s doctor uses an X-ray to aim the waves directly at the stones.
The goal after the ESWL treatment is that your child will pass the stone sand out of their body through their urine. Lots of hydration will help the sand pass. However, sometimes the sand remains in their body. If the sand stays inside long enough, the same issues that caused the kidney stone to form in the first place can cause a new stone to form from the pieces of sand. That’s why an essential part of our care is to work with you and your child to help prevent future stones from forming.
The Comprehensive Pediatric Stone Center at Children's Health brings together all the providers your child may need at the same visit. If needed, this can include nephrologists, urologists, dietitians and social workers. We are passionate about taking care of your child and treating their kidney stones, relieving pain and understanding what causes kidney stones.
Because there are no surgical tools or scopes being inserted into the child’s body, ESWL can treat even the smallest babies. Other procedures to treat kidney stones are difficult in children under age 8 because the surgical equipment isn’t small enough.
ESWL is very safe. A common side effect is a red mark about the size of a quarter where the shock waves entered the body. This mark clears up in a few days. It is expected that there will be blood in the urine. Your child may also have some discomfort after the procedure. Often, over-the-counter pain relievers (such as ibuprofen or acetaminophen) can manage their discomfort.
ESWL usually goes very well with very few risks. As with any procedure, there is always the potential for complications. While it is common to see blood in the urine, rarely, the bleeding may build up around the outside of the kidney. Usually, the body reabsorbs the blood.
On extremely rare occasions, significant complications can occur, such as:
Sometimes, your child needs an additional procedure to relieve bleeding, a blockage or an infection. Fortunately, these are quite rare and ESWL is very safe.
ESWL at Children’s Health is effective at successfully breaking down kidney stones about 85% of the time. This rate is slightly higher than the national average.
In many ways, ESWL is like other surgeries and procedures.
Here’s what you can expect before ESWL:
On the day of the procedure, the care team takes your child to the preoperative area. Your child receives liquid medicine to calm them. The child is then taken to the operating room and given anesthesia to put them asleep. We place your child on a special bed that has a cutout shaped like the letter D. Your child will lie in a position that places their kidney over the cutout. The care team brings a water balloon to the cutout, so your child is resting on the water balloon.
The doctor uses an X-ray to see the stone in your child’s kidney. Often, the doctor will move your child a few times to aim at the stone(s) from different angles. The entire bed can move so that the ESWL machine (the lithotripter) can aim the shock waves right at the stone.
The procedure takes about an hour. We ask at least one parent or guardian to remain in the hospital during your child’s procedure.
The care team brings your child to the recovery room. Here, you can be with your child. When your child is ready to go home, the nurse reviews all the instructions for medications, home care and any follow-up appointments.
We recommend that you give your child both acetaminophen and ibuprofen for the first two to three days to manage pain. For example, you first give a dose of acetaminophen, then three to four hours later, you give a dose of ibuprofen. Then three to four hours later, you give acetaminophen again, and so on. Rotating over-the-counter medicines in this way helps relieve a child’s pain without using potentially addictive medications.
Your child should be able to return to their normal activities after one to two days.
Some questions you may want to ask your doctor include:
We consider ESWL a surgery because it takes place in an operating room and your child will have anesthesia. However, ESWL is noninvasive, which means that no tools or equipment will enter their body. Only shockwaves from the lithotripter enter their body. Most of the time the surgeon has to cut to do the surgery, but not with ESWL.
Kidney stones are not very common in children, especially younger children under age 8. If you have a family history of kidney stones, then your child is more likely to develop them. What your child eats and drinks can also contribute to kidney stones. Your will doctor work with you on strategies for preventing future kidney stones in your child.