A man in his 40s presented with a sharp, stabbing pain in his right flank that had begun a few days earlier. At first, he thought it was a simple muscle strain, but as the pain intensified and was accompanied by vomiting, he sought medical attention. The diagnosis was a urinary stone. Surprised by the severity of the pain, which significantly interfered with daily life, he opted for prompt treatment and underwent extracorporeal shock wave lithotripsy (ESWL).
Urinary stones are a common condition that many people experience at least once in their lifetime. According to domestic statistics, the lifetime prevalence is approximately 8.8%, with men affected about two to three times more frequently than women. However, in recent years, the incidence among women has also been increasing due to changes in diet and lifestyle. Urinary stones are particularly common in individuals aged 30 to 50, as well as those with obesity, diabetes, or metabolic disorders. As stones move from the kidney down the ureter, they can cause severe flank pain, hematuria, and vomiting.
Depending on the size and location, some stones may pass spontaneously. However, when pain is severe or the stone is too large to pass naturally, active treatment is required. Among the available options, ESWL is a non-invasive and relatively simple method widely used to treat urinary stones.
Extracorporeal shock wave lithotripsy works by focusing high-energy shock waves generated outside the body onto the stone, breaking it into small fragments. These shock waves create a cavitation effect within fluid, delivering high-pressure energy that targets the stone precisely. The energy is designed to minimize damage to surrounding tissues while effectively fragmenting the stone, making the procedure relatively safe.
The procedure is typically performed without hospitalization or general anesthesia. The patient lies on the treatment table, either on their back or side, while shock waves are delivered. Before the procedure, analgesics are administered to reduce discomfort, and the patient is positioned to minimize movement during treatment. Using X-ray or ultrasound guidance, the exact location of the stone is identified. Shock waves are then delivered at a rate of approximately 60 to 90 pulses per minute, totaling around 2,000 to 4,000 pulses. The procedure usually takes between 30 minutes and one hour. After treatment, the fragmented stones are expected to pass naturally through the urine.
Following ESWL, patients may experience mild pain at the treatment site, hematuria, or discomfort during urination, but these symptoms typically resolve within one to two days. In some cases, stone fragments may obstruct the ureter again, leading to recurrent pain, so careful monitoring is necessary. Medications such as nonsteroidal anti-inflammatory drugs and alpha-blockers are commonly prescribed to relieve pain and facilitate stone passage. Adequate hydration—typically 2.5 to 3 liters of fluid intake per day—is essential, along with light physical activity such as jumping exercises to help promote the passage of stone fragments.
Because urinary stones vary in size, location, and symptom severity among patients, individualized treatment planning is crucial. Beyond removing the stone, metabolic evaluation, dietary modification, and regular follow-up are important to reduce the risk of recurrence. For patients experiencing acute pain and anxiety, prompt and empathetic medical care not only provides reassurance but may also contribute positively to treatment outcomes.
Urinary stones are a manageable condition when diagnosed early and treated appropriately. If symptoms such as sudden flank pain, hematuria, or vomiting occur, it is important to seek medical attention without delay. Understanding one’s health status and maintaining consistent preventive care are key steps in reducing recurrence. As the weather becomes warmer, the incidence of urinary stones tends to increase, making proper hydration and preventive measures especially important during the summer months.