Urinary stones (urolithiasis) are a surprisingly common condition—statistically, about 8.8% of the population will experience them at some point in their lifetime. Men are affected 2 to 3 times more often than women, though rising incidence in women has been observed in recent years due to changes in diet and lifestyle. The condition is particularly prevalent among those in their 30s to 50s, as well as people with obesity, diabetes, or other metabolic disorders. When a stone forms in the kidney and begins to move down the ureter, it can cause excruciating flank pain, blood in the urine (hematuria), and nausea or vomiting.
While small stones may pass naturally, those causing severe pain or proving too large to pass independently require medical intervention. Among the available treatment options, Extracorporeal Shock Wave Lithotripsy (ESWL) is one of the most widely performed non-surgical methods for stone removal.
ESWL works by focusing high-energy shock waves generated outside the body onto the stone, breaking it into tiny fragments. The shock waves induce a cavitation effect in the fluid surrounding the stone, delivering high-pressure energy precisely to the target. Crucially, the technology is designed to minimize damage to surrounding tissue while concentrating its effect on the stone.
The procedure is typically performed without hospitalization or general anesthesia. Patients lie on a treatment table, and analgesics are administered beforehand to minimize discomfort. Using X-ray and ultrasound imaging to precisely locate the stone, shock waves are then delivered at a rate of approximately 60 to 90 pulses per minute, for a total of 2,000 to 4,000 pulses. The session typically lasts 30 minutes to an hour, after which the fragmented stone passes naturally through the urine.
After the procedure, mild pain at the treatment site, blood in the urine, and some discomfort during urination are common but typically resolve within 1 to 2 days. Occasionally, stone fragments may re-obstruct the ureter, causing a recurrence of pain, which requires close monitoring. Anti-inflammatory painkillers and alpha-blocker medications are prescribed to ease discomfort and facilitate stone passage. Staying well-hydrated—drinking 2.5 to 3 liters of water daily—and light physical activity such as jump rope exercises can help speed up stone clearance.
Because every patient's stone differs in size, location, and symptom severity, personalized treatment is essential. Beyond simply removing the stone, metabolic testing combined with dietary adjustments and regular follow-up appointments can significantly reduce the risk of recurrence.
Urinary stones are a manageable condition with timely and accurate diagnosis. If you experience sudden flank pain, hematuria, or vomiting, it is advisable to visit a medical institution promptly. Above all, understanding your own body and committing to ongoing management is the first step in preventing recurrence.
By Dr. Choi Ho-cheol, Director at Goldman Urology (Dongtan Branch)