No incision. No scope inside the urinary tract.
Focused shockwaves reach the stone from outside your body. Fragments then pass in the urine.
Home / Stent-Free Treatment
Stent-free kidney stone treatment
Bring your imaging and hospital records. We review your stone’s size, location and density, your symptoms and your health, then recommend a plan. ESWL suitability and timing are individual.
What a ureteral stent is — and why it matters
A ureteral stent is a temporary tube between the kidney and bladder to help urine drain. It is not routinely required for ESWL; when one is needed, we explain why and plan its removal.
Stents work. But for many patients they are genuinely miserable, and that downside is often under-discussed before a procedure.
What the research says about living with a stent
The discomfort is well documented. In the validation study for the Ureteral Stent Symptom Questionnaire — the standard tool urologists use to measure this — most patients reported real, daily disruption:
- 78% reported bothersome urinary symptoms — urinary frequency, urgency, incontinence, and blood in the urine.
- More than 80% had stent-related pain affecting daily activities, with overall quality of life reduced in roughly 80% of patients.
- About a third reported sexual dysfunction, and well over half reported reduced work capacity while the stent was in place.
A separate long-term prospective study tracking thousands of stented patients found these symptoms peaked within the first week and that quality of life typically only returned to baseline around two weeks after the stent was removed. In other words, the stent can be a two-to-three-week problem in its own right — on top of the stone.
Why shockwave lithotripsy is different
ESWL focuses shockwaves on the stone from outside the body. The fragments then pass in the urine. We review imaging and follow-up needs with you before treatment.
A stent is not routinely needed for ESWL. Some patients still need drainage or a stent for safety.
There are exceptions. Some patients undergoing ESWL — for example with a larger stone burden, a solitary kidney, or specific anatomy — may still have a stent placed for safety. We will always tell you in advance whether a stent is part of your plan and why.
The bottom line for patients
If avoiding a stent matters to you, it is worth finding out whether your stone is a good ESWL candidate before defaulting to a procedure that usually includes one. Stent tolerance varies enormously between people — but the data is clear that for a large share of patients, the stent is the part they remember most.
Find out if you can avoid a stent
Send your CT or book an evaluation, and we'll tell you honestly whether shockwave lithotripsy is an option for your stone.
Am I a candidate for ESWL?Come in for a kidney stone evaluation
Office ESWL
How ESWL worksWhat actually happens during a shockwave treatment.
Selected references
- Joshi HB, et al. Ureteral Stent Symptom Questionnaire: development and validation of a multidimensional quality of life measure. J Urol. 2003.
- Joshi HB, et al. Indwelling ureteral stents: evaluation of symptoms, quality of life and utility. J Urol. 2003.
- Ureteral stent–related symptoms: systematic review and network meta-analysis. J Urol. 2024.
A simpler treatment day, when ESWL is right for you.
Stay in your own clothes.
For our office ESWL protocol, you can remain in your own clothes; the team adjusts clothing at the treatment area as needed for skin contact and imaging. Preparation depends on your care plan.
A stent is rarely needed in our selected ESWL patients.
Dr. Shusterman describes stents as uncommon in his selected office ESWL patients. This is practice experience, not a measured percentage or a promise. A stent may still be needed for blockage, infection or difficulty passing fragments.
Fast visit. Individual preparation.
Your appointment includes imaging review, treatment and recovery. If your plan uses sedation, follow fasting instructions, arrange an escort and do not drive afterward. The team confirms timing before your visit.