Kidney stones are hard, tiny particles that may develop in your kidneys. Sometimes kidney stones remain silent and cause no discomfort, but in other cases they can trigger severe pain, difficulty passing urine or even nausea.
If you have a kidney stone, you might have heard about Laser treatment (RIRS) and Shockwave therapy (ESWL). Both are new treatments that can take out stones without big surgery. But which is best for you? In this blog, we will provide full information regarding this question
Laser Treatment for Kidney Stones (RIRS)
This treatment for kidney stones is known as RIRS. The minimally invasive procedure uses a flexible scope with a laser and does not require any cuts to the body.
Step by Step Process
- Anesthesia: The patient is given anesthesia so they do not feel any pain during the procedure.
- Scope Insertion: A thin flexible scope is gently passed through the urinary passage
- Stone Location : The doctor identifies the stone using a tiny camera on the scope.
- Laser Breaking: A Holmium or Thulium laser is used to break the stone into fine dust or small fragments.
- Stone Removal:
- Very fine dust passes out naturally with urine.
- If fragments are larger, the doctor may use tiny baskets to remove them.
- Stent Placement (if needed): A temporary stent which is a small tube, may be placed inside the ureter to keep urine flowing smoothly and help with healing
Benefits of Laser Treatment
| Benefit | Why It Helps |
| No cut surgery | The procedure is done through the natural urinary passage |
| High success rate | 95–98% stones cleared in one sitting |
| Works for all stone types | Small, big, hard, or multiple stones |
| Quick recovery | Back to daily activities in 3–5 days |
| Safe | Minimal risk of bleeding or infection |
Risks and Side Effects that are Rare but Possible
- Temporary burning while passing urine (due to the stent)
- Mild infection (treated with antibiotics)
- Very rarely, injury to the urinary tract
Shockwave Therapy for Kidney Stones (ESWL)
Shockwave therapy is called ESWL. It is a completely non-surgical treatment where kidney stones are broken into small pieces using strong sound waves.
Step by Step Process
- Preparation: The patient lies on a special table or a water filled cushion.
- Sedation or Pain Relief: Usually no full anesthesia is required. Sometimes mild sedation or painkillers are given.
- Stone Location: X-ray or ultrasound is used to locate the exact position of the stone.
- Shockwave Delivery: A machine sends high energy sound waves from outside the body to target the stone.
- Stone Fragmentation: The stone breaks into small pieces.
- Passing Fragments: These fragments pass naturally through urine over the next few days or weeks.
Benefits of Shockwave Therapy
| Benefit | Why It Helps |
| No cuts, no surgery | Energy waves work from outside the body |
| Quick procedure | Usually completed in 45–60 minutes |
| Outpatient treatment | Go home the same day |
| Safe | Minimal risk of complications |
| Good for children and the elderly | Avoids anesthesia in most cases |
Risks and Side Effects (Rare but Possible)
- Pain while passing fragments
- Small pieces may remain, causing recurrence
- Blood in urine for a short time
- Not suitable for pregnant women, people with bleeding disorders or very large and hard stones
Pros and Cons of Laser Treatment
Pros:Laser treatment is very effective especially when treating large or hard stones. This procedure is highly effective and usually removes the stones in a single session. The procedure is minimally invasive and it’s done through the urinary system. There are no large cuts. This tool is suitable for all sizes and types of stones. It’s a good choice for complicated cases.
Cons: Laser treatment requires anesthesia which may not be suitable for everyone. A short hospital stay of 1–2 days is usually needed. Sometimes a temporary stent is placed to help urine flow which can cause mild discomfort. Overall the cost is slightly higher compared to Shockwave therapy.
Pros and Cons of Shockwave Therapy (ESWL)
Pros: The treatment is non-invasive and it can be done as an outpatient procedure. Patients are then able to return home the same day. The initial recovery period after the procedure is brief and relatively painless. It is a good choice for patients with small or soft stones and those who prefer a less invasive procedure.
Cons: Shockwave therapy works best only for small stones and may not be effective for larger or very hard stones. Some patients may require 2–3 sessions to fully break the stone. Passing the stone fragments afterward can cause discomfort and the overall success rate is slightly lower 70–80% compared to Laser treatment.
Age Suitability
- Children: ESWL is usually safer because it avoids anesthesia.
- Young adults (18–40 yrs): Both are fine, the choice depends on stone size.
- Middle aged (40–60 yrs): Laser is preferred for larger stones.
- Elderly people aged above 60 years: Doctors decide case by case. ESWL may be safer if the anesthesia risk is high.
Safety and Risks
- Laser (RIRS): Safe but requires anesthesia and stent placement in some cases.
- Shockwave (ESWL): Safe but not suitable for pregnant women, bleeding disorders or very large stones.
FAQS
Q1. Which is less painful?
ESWL is painless during the procedure, but fragments that pass later can hurt. RIRS is done under anesthesia, so you don’t feel pain during the procedure.
Q2. Can kids undergo laser treatment?
Yes, but doctors usually prefer ESWL for children.
Q3. Do stones return after treatment?
Yes, stones can return if lifestyle and diet are not managed.
Choosing the Right Kidney Stone Treatment: Expert Advice from Dr. Deepanshu Gupta
The effectiveness of both Laser (RIRS) and Shockwaves (ESWL) depends on the size and type of the kidney stone, as well as the health and condition of the patient. Shockwave (ESWL), a non-surgical outpatient treatment, is best for small stones. Laser (RIRS:) Best for large or difficult stones. Higher chances of clearing them in one go.
For the best treatment advice, consult Dr. Deepanshu Sharma. He has over 14 years of experience as a kidney stone specialist. He is known as a Laser and Shockwave specialist and for his expertise and care of patients in minimally invasive urology.