Urinary stones (urolithiasis) are one of the most common urological conditions, with a lifetime occurrence rate that affects people of all backgrounds. While the condition has traditionally been more prevalent in men, recent changes in dietary habits and lifestyle have led to a rising incidence in women as well. In particular, people in their 30s to 50s and those with obesity, diabetes, or metabolic disorders are at higher risk. When a stone forms and begins moving from the kidney down the ureter, it can cause excruciating flank pain, blood in the urine, and nausea or vomiting.
Depending on the size and location, some stones may pass naturally. However, when pain is severe or the stone is too large to pass on its own, active treatment becomes necessary. Among the available options, Extracorporeal Shock Wave Lithotripsy (ESWL) is widely regarded as a non-surgical, relatively straightforward method for stone removal.
ESWL works by focusing high-energy shock waves generated outside the body onto the stone's precise location, breaking it into tiny fragments. The shock waves create a cavitation effect within fluid, transmitting high-pressure energy that reaches the stone and shatters it. Crucially, the waves are designed to concentrate solely on the stone, causing minimal damage to the surrounding tissue.
The procedure is typically performed without hospitalization or general anesthesia. The patient lies on the treatment table and receives shock waves while remaining still after pain medication is administered. Using X-ray and ultrasound to pinpoint the stone's exact position, the device delivers approximately 60 to 90 pulses per minute for a total of 2,000 to 4,000 pulses. Each session lasts roughly 30 minutes to an hour, after which the fragmented stone passes naturally through the urine.
Post-procedure effects—such as mild pain, 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 that requires close monitoring. After the procedure, anti-inflammatory painkillers and alpha-blocker medications are prescribed to reduce discomfort and facilitate stone passage. Staying well-hydrated (2.5 to 3 liters of water daily) and engaging in light physical activity such as jump rope exercises are also strongly recommended to speed up stone clearance.
It is important to remember that every patient's stone differs in size, location, and symptom severity, making personalized treatment essential. Beyond simply removing the stone, metabolic testing combined with dietary improvements and regular follow-up visits are the best way to lower the risk of recurrence.
Dr. Ryu Je-man of Goldman Urology (Seoul Station branch) stated, "Kidney stones are entirely manageable when diagnosed accurately and treated appropriately at an early stage. If you experience sudden flank pain, blood in the urine, or vomiting, do not wait—seek medical attention promptly. Above all, understanding your own body and committing to consistent self-management is the very first step in preventing recurrence."