For many centuries, surgery was the only option in treating stones that would not pass spontaneously. About 22 years ago the German aeronautics company Dornier, through groundbreaking research, developed the means for focusing external energy to treat Kidney stones and pulverize them to small fragments that are voided naturally with the urine.
This was a major advancement, perhaps one of the most significant medical advancements of the last century. Over the last 20 years lithotripter applications for renal stone therapy have been perfected, and these days Lithotripsy is performed as an out patient procedure in a painless fashion.

Extra Corporeal Shock Wave Lithotripsy (ESWL) All the kidney stone with size of up to 1.5 –2 cms can be treated with the Lithotripsy. Non impacted upper ureteric stone can be also treated with Lithotripsy

For this treatment the patient lies on a special couch. X-ray and/or ultrasound are used to target the stone, and by a computerized system the stone is placed at the focal point of the energy source of the lithotripter. Having realized the stone, the shock waves are delivered through a remote control, which leads to fragmentation of stone into fine particles.
Treatment usually lasts about 45 minutes.

Post lithotripsy :
After the procedure is complete, the patient is kept under observation for an hour then he is allowed to return home. He is asked to take plenty of liquid orally to maintain his urinary output to 2-2.5 litres per 24 hrs. He may require some antibiotics and some painkiller. It takes few to several weeks for final stone fragments to pass out through urine. The patient may experience some burning sensation and blood in urine for few days. The patient is generally advised to do routine urine test with X- ray KUB for 7-10 days.
The patient rests for a while and then is allowed to return home. Sometimes a "stent" is placed in the ureter if it is anticipated that the stone fragments may block the ureter after Lithotripsy. Repeat sessions of Lithotripsy may be required, usually not earlier than 3-5 days.
However, all urologists realize that Lithotripsy is, sadly not an answer to many of the stones seen in day-to-day practice. The reason is that for stones that are more than 2 cms in size, branched stones and various other complicated situations Lithotripsy is either not effective or is slow to work with patients needing multiple procedures and hospital visits. In these patients, other options should be considered. In an average practice in India, where patients present with advanced and neglected disease, at least 40% of kidney stones fall into this category. These larger stones are removed by a new technique called Percutaneous Nephrolithotomy or PCNL.