Break Up Stones Without Surgery
Kidney stones can be very painful and make daily life difficult, but surgery is not always needed. Extracorporeal Shock Wave Lithotripsy (ESWL), or shockwave lithotripsy, is a non-invasive treatment that uses focused sound waves to break kidney stones into smaller pieces.
At East Coast Advanced Urology in Clifton, NJ, Dr. Karl Coutinho provides individualized kidney stone treatment. He welcomes patients from throughout the greater New Jersey & New York City metropolitan area and carefully evaluates each stone to determine whether shockwave lithotripsy or another treatment may be the most appropriate approach.
Shockwave lithotripsy is a non-surgical way to treat certain kidney and upper ureteral stones.
During the procedure, high-energy sound waves are sent through your skin and focused on the stone. These waves slowly break the stone into tiny pieces, which you can pass in your urine over the next few days or weeks.
Since there are no incisions, ESWL is one of the least invasive treatment options for the right patients.
Shockwave lithotripsy works well for many people, but it is not the best treatment for every kidney stone. The size, location, and characteristics of your stone may make another procedure more appropriate. Additional treatment may also be necessary if stone fragments remain after ESWL. Dr. Coutinho will recommend an approach based on your individual situation.
If a stone is too large, too dense, or located in an area where shockwave treatment may be less effective, ureteroscopy with laser lithotripsy allows Dr. Coutinho to directly visualize the stone, break it apart with a laser, and remove the fragments.
A temporary ureteral stent may be used in certain cases to keep the ureter open and allow urine to drain from the kidney. A stent may also be necessary if stone fragments cause a blockage or another procedure is planned.
Cystolitholapaxy is used to treat stones located in the bladder rather than the kidney or ureter. During the procedure, Dr. Coutinho uses a scope to locate the bladder stone, then breaks it into smaller pieces that can be removed.
At your consultation, Dr. Coutinho will assess the size, location, and characteristics of your kidney stone to determine whether shockwave lithotripsy is the best choice for you. We will also consider your overall health, urinary anatomy, and the likelihood of passing the stone fragments.
You may be a good candidate if you:
Shockwave lithotripsy is an effective and minimally invasive option for many people with kidney stones, and since it does not require surgery, most patients can recover faster compared to more invasive treatments. Compared with ureteroscopy, shockwave lithotripsy generally has lower procedural morbidity but also a lower chance of complete stone clearance after a single treatment. Some patients require a second ESWL session or another procedure if fragments remain.
Other benefits include:
Shockwave lithotripsy is not appropriate for every patient or every type of kidney stone. Dr. Coutinho may recommend another treatment if the stone is unlikely to respond well to shockwave therapy or if medical concerns could make the procedure unsafe.
ESWL may not be recommended for patients who are pregnant, have an active urinary tract infection, have certain bleeding problems, or have a blockage that could prevent stone fragments from passing. The size, location, and composition of the stone can also make another treatment a better option.
Your kidney stone treatment begins with a careful evaluation by Dr. Coutinho. He will review your symptoms, imaging, test results, and overall health before determining which treatment may be best for you.
Shockwave lithotripsy is typically performed as an outpatient procedure, allowing you to go home the same day. After you check in, you will meet the care team and receive sedation or anesthesia to keep you comfortable during treatment.
You will lie on a treatment table while ultrasound or X-ray imaging is used to find the kidney stone. Dr. Coutinho can then direct the shock waves toward the stone, breaking it into pieces small enough to pass in your urine.
The procedure usually takes about 45 to 60 minutes. Once it is finished, you will be monitored for a short period before going home. The team will also give you recovery instructions, including information about fluids, activity, and follow-up care.
Your Guide to Post-Shockwave Lithotripsy Care
Most people recover quickly after shockwave lithotripsy and can gradually return to their usual activities as they begin to feel better. Mild soreness, some blood in your urine, or discomfort as stone pieces pass is common. These symptoms should improve as you recover.
Dr. Coutinho may recommend drinking plenty of fluids to help stone fragments pass through the urinary tract. You may also be asked to strain your urine so that any stone pieces can be collected and checked.
Follow-up imaging may be performed to see how well the stone has broken apart and whether fragments remain in the urinary tract. Dr. Coutinho will provide instructions regarding activity, pain management, and when you can safely return to work, exercise, and other parts of your normal routine.
The cost of shockwave lithotripsy (ESWL) in Clifton, NJ, and the greater New York metropolitan area can vary depending on the size and location of your kidney stone, the complexity of your treatment, the type of anesthesia used, and your insurance coverage.
Insurance coverage for shockwave lithotripsy will depend on your individual plan. Before treatment, our team can help review your benefits and explain any costs you may be responsible for.
Dr. Karl Coutinho offers both shockwave lithotripsy and ureteroscopy for urinary stones. This allows the procedure to be selected based on stone size, location, density, visibility on imaging, urinary anatomy, symptoms, and the likelihood that fragments will pass, rather than defaulting to one treatment for every stone.
He completed urology residency at Mount Sinai Hospital followed by fellowship training in genitourinary trauma and reconstruction at Northwestern Memorial Hospital and University Hospitals of Cleveland. His approach emphasizes appropriate patient selection, because the convenience of a noninvasive procedure is most valuable when the stone has characteristics that make successful fragmentation and clearance reasonably likely.
East Coast Advanced Urology
If you have symptoms of kidney stones or have already been diagnosed with one, schedule a consultation with Dr. Karl Coutinho at East Coast Advanced Urology in Clifton, NJ. He can evaluate your condition, review your treatment options, and determine whether shockwave lithotripsy may be appropriate for you.
Dr. Coutinho welcomes patients from throughout the greater New York metropolitan area. Contact East Coast Advanced Urology to schedule your consultation.