Urinary stones are a relatively common condition that many people may experience at least once in their lifetime. According to domestic statistics, the lifetime risk of developing urinary stones is about 8.8%, and the condition occurs approximately two to three times more frequently in men than in women. In recent years, however, the incidence among women has also been increasing due to changes in dietary habits and lifestyle patterns. Urinary stones are particularly common among individuals in their 30s to 50s and among those with obesity, diabetes, or metabolic disorders. When stones form in the kidney and move down the ureter, they can cause severe flank pain along with symptoms such as hematuria and vomiting.
Depending on their size and location, some urinary stones can pass naturally through the urine. However, treatment is often required when the pain is severe or when the stone is too large to pass spontaneously. Among the available treatment options, extracorporeal shock wave lithotripsy (ESWL) is widely used because it is a non-surgical and relatively simple method for breaking down stones.
Extracorporeal shock wave lithotripsy works by focusing high-energy shock waves generated outside the body onto the stone, breaking it into small fragments. The shock waves create a cavitation effect within the surrounding fluid, delivering high-pressure energy to the stone. This energy breaks the stone apart while minimizing damage to surrounding tissues. The treatment is carefully targeted so that the shock waves concentrate primarily on the stone itself.
In most cases, the procedure is performed without hospitalization or general anesthesia. The patient lies on or beside the treatment machine while receiving shock waves. Pain relievers are usually administered beforehand to reduce discomfort, and the patient is positioned in a stable posture to minimize movement during the procedure. Using X-ray or ultrasound imaging, the physician identifies the exact location of the stone and delivers shock waves at a rate of about 60 to 90 pulses per minute, typically totaling between 2,000 and 4,000 shocks. The procedure usually takes between 30 minutes and one hour, after which the fragmented stones pass naturally through the urine.
After the procedure, mild pain in the treated area, hematuria, or discomfort during urination may occur, but these symptoms generally improve within one to two days. In some cases, stone fragments may temporarily block the ureter again, causing recurrent pain, so careful observation is necessary. After treatment, patients are often prescribed anti-inflammatory pain relievers and alpha-blocker medications to reduce discomfort and help facilitate stone passage. Drinking approximately 2.5 to 3 liters of water per day and engaging in light physical activities such as jumping exercises can also help promote the elimination of stone fragments.
Because the size, location, and severity of symptoms vary from patient to patient, personalized treatment is essential for urinary stone management. Beyond simply removing the stone, metabolic evaluation, dietary adjustments, and regular follow-up examinations can help reduce the likelihood of recurrence.
With early diagnosis and appropriate treatment, urinary stones can be effectively managed. If symptoms such as sudden flank pain, hematuria, or vomiting occur, it is advisable to visit a medical institution promptly for evaluation. Understanding one’s physical condition and maintaining consistent preventive care are key steps in reducing the risk of recurrence.
Written by
Dr. Choi Ho-cheol
Goldman Urology Clinic, Dongtan Branch