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How many days of rest are needed after extracorporeal shock-wave lithotripsy (ESWL)?

Patients should rest for at least three days after extracorporeal shock-wave lithotripsy (ESWL); the exact period is adjusted according to how smoothly the stone fragments pass.

The repeated shock waves produce mild trauma to the kidney or ureter, leading to localized edema and sometimes small mucosal tears. This explains the slight abdominal pain or discomfort commonly felt after the procedure. Provided the symptoms are tolerable, no extra intervention is required.

Post-ESWL routine

  • Drink plenty of water
  • Perform gentle activity (walking) to help gravel descend
  • Avoid strenuous exercise, which can intensify pain while edema is present

Minimum 3-day rest is advised. On the third day, if pain and hematuria have resolved, the patient returns for imaging:

  • No residual fragments → resume normal work and life
  • Residual stones → second lithotripsy session and a longer rest period

Additional advice: stay relaxed, and refrain from spicy or irritating foods.

ItemInstructions / Time-frame
Minimum rest3 days
Why rest?Renal/ureteral edema or small mucosal tears caused by shock waves
Allowed activitiesPlenty of water, gentle walking to help fragments pass
ForbiddenStrenuous exercise (worsens pain & edema)
Review on day 3Imaging check:
• No residual stonesResume normal activity
• Residual stonesSecond ESWL → longer rest
Diet & moodStay relaxed; avoid spicy / irritating foods