Is it true that the size of stone increases after ESWL?

Q. Is it true that the size of stone increases after ESWL?

Answered by
Dr. Saurabh Subhash Pandya
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 12, 2016 and last reviewed on: Jun 26, 2023

Hello doctor,

I had my ESWL done 14 days ago. I was not completely sedated and felt some pain so I was shaking a bit. The day after ESWL, I started feeling severe pain in kidney, irritation and burning in stomach. Pain was dealt with but burning in stomach continued and I was constipated too. Due to the above reasons I got admitted in a Gastro hospital for four days. They told me it was a case of gastritis. When my condition got better, I was discharged. I visited my urologist and he suggested for inserting stent as I had blockage. He suggested it for pain relief and easy passage of stones, so I had it inserted. I feel very little pain now after stent. But, the problem is that I am still constipated and mild burning in stomach. Is this a kind of complication after ESWL? I had ESWL for a 0.39 inch stone which was broken into fragments. But, after that I had an ultrasound and was diagnosed with an 11 mm stone which was never present before. When I asked my urologist about it, he said that it is not a complete stone but fragments looking enlarged. Is it true?



Welcome to

Post ESWL (extracorporeal shock wave lithotripsy) the stone fragments need to be flushed out by the kidney. So, you need to have lots of fluids. Adding a painkiller and an alpha blocker to relax your ureters will help clear the fragments. Pain can occur after ESWL due to fragments passing down. Pain is on flank and radiates to groin. If pain is in upper or central abdomen it may be due to gastritis, which may due to painkillers. Stone size increases slightly after ESWL because there is cracking up of stone but the fragments are still together due to lack of space. So, initially size may appear larger. However, usually the radiologist sees upper end of stent in kidney and mistakes it for a stone. So, an x-ray is best post ESWL.

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