{"id":10181,"date":"2026-05-06T20:00:00","date_gmt":"2026-05-06T13:00:00","guid":{"rendered":"https:\/\/drsoaraweeurology.com\/?p=10181"},"modified":"2026-05-03T16:58:36","modified_gmt":"2026-05-03T09:58:36","slug":"evolution-of-stone-treatment-eswl","status":"publish","type":"post","link":"https:\/\/drsoaraweeurology.com\/th\/2026\/05\/06\/evolution-of-stone-treatment-eswl\/","title":{"rendered":"\u0e27\u0e34\u0e27\u0e31\u0e12\u0e19\u0e32\u0e01\u0e32\u0e23\u0e02\u0e2d\u0e07\u0e01\u0e32\u0e23\u0e23\u0e31\u0e01\u0e29\u0e32\u0e01\u0e49\u0e2d\u0e19\u0e19\u0e34\u0e48\u0e27: \u0e08\u0e32\u0e01\u0e2a\u0e21\u0e23\u0e20\u0e39\u0e21\u0e34\u0e23\u0e1a\u0e2a\u0e39\u0e48\u0e01\u0e32\u0e23\u0e23\u0e31\u0e01\u0e29\u0e32\u0e14\u0e49\u0e27\u0e22\u0e40\u0e17\u0e04\u0e42\u0e19\u0e42\u0e25\u0e22\u0e35\u0e02\u0e31\u0e49\u0e19\u0e2a\u0e39\u0e07"},"content":{"rendered":"\n<div class=\"wp-block-columns coblocks-author-columns has-background is-layout-flex wp-container-core-columns-is-layout-7537815b 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8.365 8.365 0 0 0-.078.53 9 9 0 0 0-.05.727c-.01.282-.013.621-.013 1.016a31.121 31.121 0 0 0 .014 1.017 9 9 0 0 0 .05.727 7.946 7.946 0 0 0 .077.53h.001c.024.115.06.262.112.438.243.743.65 1.303 1.213 1.68.565.376 1.255.564 2.073.564.8 0 1.536-.213 2.105-.603.57-.39.94-.916 1.175-1.65.076-.235.135-.558.177-.93a15.4 15.4 0 0 0 .063-1.207v-.512a.27.27 0 0 0-.273-.273h-2.95a.27.27 0 0 0-.274.273v.785c0 .228.0.343.273.343h1.337c.094 0 .14.045.14.137 0 .61-.063 1.043-.155 1.318-.182.546-.7 1.018-1.683 1.018-.654 0-1.135-.114-1.475-.356-.34-.244-.55-.585-.658-1.024a3.797 3.797 0 0 1-.111-.43 5.515 5.515 0 0 1-.06-.51 19.85 19.85 0 0 1-.025-.726c-.004-.28-.004-.628-.004-1.045 0-.418 0-.766.004-1.046a19.85 19.85 0 0 1 .025-.726 5.475 5.475 0 0 1 .06-.51 3.785 3.785 0 0 1 .111-.43c.108-.44.318-.78.658-1.024.34-.243.82-.357 1.475-.357.6 0 1.064.078 1.413.293.347.215.595.515.74.91.063.155.166.21.31.156l.967-.4c.15-.058.187-.18.13-.32a3.025 3.025 0 0 0-1.262-1.452C21.12.218 20.428.0 19.586 0zM8.512 4.32c-2.7 0-4.066.997-4.066 3.06v.04c0 1.92.992 2.83 3.046 2.83 1.27 0 2.038-.39 2.385-1.05h.13l.067.51c.04.2.207.34.41.34h.99V7.95c0-2.59-1.06-3.63-2.962-3.63zm-.18 1.61c1.118 0 1.628.56 1.628 1.86v.4l-1.65.16c-1.35.13-1.86.46-1.86 1.13v.04c0 .67.41 1.06 1.45 1.06.85 0 1.55-.32 1.93-.84.04-.06.13-.07.18-.02.05.03.07.1.07.16v.43c0 .26.13.42.34.42h1.05c.21 0 .34-.16.34-.42v-3.6c0-1.94-1.13-2.83-3.46-2.83-1.94 0-3.07.86-3.4 2.04l1.55.45c.18-.69.6-1.04 1.83-1.04z\"\/>\n    <\/svg>\n  <\/a>\n  \n  <a href=\"https:\/\/orcid.org\/0009-0004-8387-3559\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"ORCID iD\"\n     aria-label=\"View ORCID Profile\"\n     style=\"text-decoration: none; color: #A6CE39; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M12 0C5.372 0 0 5.372 0 12s5.372 12 12 12 12-5.372 12-12S18.628 0 12 0zM7.369 4.378c.525 0 .947.431.947.947 0 .525-.422.947-.947.947-.525 0-.946-.422-.946-.947 0-.525.421-.947.946-.947zm-.722 3.038h1.444v10.041H6.647V7.416zm3.562 0h3.9c3.712 0 5.344 2.653 5.344 5.025 0 2.578-2.016 5.025-5.325 5.025h-3.919V7.416zm1.444 1.303v7.444h2.297c3.272 0 4.022-2.484 4.022-3.722 0-2.016-1.284-3.722-4.097-3.722h-2.222z\"\/>\n    <\/svg>\n  <\/a>\n  \n  <a href=\"https:\/\/scholar.google.com\/citations?user=lTgsRMUAAAAJ&#038;hl=en\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"Google Scholar\"\n     aria-label=\"View Google Scholar Profile\"\n     style=\"text-decoration: none; color: #4285F4; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M5.242 13.769L0.5 9.5 12 1l11.5 8.5-4.742 4.269C17.548 11.249 14.978 9.5 12 9.5c-2.977 0-5.548 1.748-6.758 4.269zM12 10a7 7 0 1 0 0 14 7 7 0 0 0 0-14z\"\/>\n    <\/svg>\n  <\/a>\n  \n<\/div>\n\n\n\n<p>Welcome to a journey through the history and science of one of the most transformative technologies in modern urology: <strong>Extracorporeal Shockwave Lithotripsy (ESWL)<\/strong>. As a board-certified urologist specializing in kidney stone treatment, I want to share with you how a wartime observation evolved into one of the most elegant non-invasive procedures we offer today.<\/p>\n\n\n\n<p>This article is drawn from my official presentation delivered at the <strong>Royal Phnom Penh Urology Seminar on November 17, 2018<\/strong>. That seminar remains a meaningful milestone in my career \u2014 a moment where we connected the historical roots of medical innovation to the cutting-edge solutions I now provide to patients at Bangkok Hospital Headquarters and Samitivej Sriracha Hospital.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"600\" data-attachment-id=\"10249\" data-permalink=\"https:\/\/drsoaraweeurology.com\/th\/the-evolution-of-stone-treatment-6-things-to-know-about-eswl\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/The-Evolution-of-Stone-Treatment-6-Things-to-Know-About-ESWL.jpg?fit=800%2C600&amp;ssl=1\" data-orig-size=\"800,600\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"The Evolution of Stone Treatment \u2014 6 Things to Know About ESWL | Visual Summary by Dr. Soarawee\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;The Evolution of Stone Treatment \u2014 6 things you should know about ESWL&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/The-Evolution-of-Stone-Treatment-6-Things-to-Know-About-ESWL.jpg?fit=800%2C600&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/The-Evolution-of-Stone-Treatment-6-Things-to-Know-About-ESWL.jpg?resize=800%2C600&#038;ssl=1\" alt=\"Visual summary infographic by Dr. Soarawee Weerasopone \u2014 6 things to know about the evolution of Extracorporeal Shockwave Lithotripsy (ESWL) from WWII shockwave observations to today's 4th-generation radiation-free kidney stone treatment\" class=\"wp-image-10249\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/The-Evolution-of-Stone-Treatment-6-Things-to-Know-About-ESWL.jpg?w=800&amp;ssl=1 800w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/The-Evolution-of-Stone-Treatment-6-Things-to-Know-About-ESWL.jpg?resize=300%2C225&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/The-Evolution-of-Stone-Treatment-6-Things-to-Know-About-ESWL.jpg?resize=768%2C576&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/The-Evolution-of-Stone-Treatment-6-Things-to-Know-About-ESWL.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">The Evolution of Stone Treatment \u2014 6 things you should know about ESWL<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">What Exactly is a Shockwave?<\/h2>\n\n\n\n<p>To understand how we break kidney stones without a single incision, we must first understand the physics of the \u201cshockwave.\u201d In scientific terms, a shockwave is a <strong>sharp change of pressure in a narrow region traveling through a medium<\/strong> such as air or water. These waves are typically caused by explosions or by bodies moving faster than the speed of sound.<\/p>\n\n\n\n<p>In urology, we harness this energy and aim it with precision. Think of it like a focused beam of sound energy: much like a magnifying glass focuses sunlight onto a single point to create heat, an ESWL machine focuses shockwaves onto a kidney stone to create mechanical stress, eventually shattering the stone into \u201cdust\u201d or small fragments that can be passed naturally in the urine.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">A Surprising History: From Battlefields to Hospitals<\/h2>\n\n\n\n<p>The history of ESWL is a classic example of <em>dual-use technology<\/em> \u2014 where a discovery in one field changes another entirely.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>The World War II Connection:<\/strong> During WWII, it was observed that sailors and soldiers in the vicinity of underwater depth charge explosions suffered severe lung injuries \u2014 even when they had no visible external wounds. This proved that shockwaves could travel through water and the human body to affect internal structures.<\/li>\n\n\n\n<li><strong>The Breakthrough (1980):<\/strong> Decades of research into high-energy physics eventually led to a medical breakthrough. On <strong>February 7, 1980<\/strong>, the very first human treatment using a first-generation Extracorporeal Shockwave Lithotripter was performed in Germany. This single event changed urology forever, transforming what used to be major open surgeries into non-invasive procedures.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"10190\" data-permalink=\"https:\/\/drsoaraweeurology.com\/th\/this-picture-show-how-prof-christian-chaussy-operated-his-first-patient-he-put-his-patient-into-1-eswl-water-fill-tank\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/This-picture-show-how-Prof.-Christian-Chaussy-operated-his-first-patient.-He-put-his-patient-into-1-ESWL-water-fill-tank.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"First ESWL Treatment by Prof. Christian Chaussy in Water Bath \u2014 History of Kidney Stone Treatment\" data-image-description=\"\" data-image-caption=\"\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/This-picture-show-how-Prof.-Christian-Chaussy-operated-his-first-patient.-He-put-his-patient-into-1-ESWL-water-fill-tank.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/This-picture-show-how-Prof.-Christian-Chaussy-operated-his-first-patient.-He-put-his-patient-into-1-ESWL-water-fill-tank.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Prof. Christian Chaussy performing the world's first ESWL kidney stone treatment in 1980 \u2014 patient submerged in a water-filled tank, the original first-generation Extracorporeal Shockwave Lithotripsy procedure in Munich, Germany\" class=\"wp-image-10190\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/This-picture-show-how-Prof.-Christian-Chaussy-operated-his-first-patient.-He-put-his-patient-into-1-ESWL-water-fill-tank.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/This-picture-show-how-Prof.-Christian-Chaussy-operated-his-first-patient.-He-put-his-patient-into-1-ESWL-water-fill-tank.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/This-picture-show-how-Prof.-Christian-Chaussy-operated-his-first-patient.-He-put-his-patient-into-1-ESWL-water-fill-tank.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/This-picture-show-how-Prof.-Christian-Chaussy-operated-his-first-patient.-He-put-his-patient-into-1-ESWL-water-fill-tank.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/This-picture-show-how-Prof.-Christian-Chaussy-operated-his-first-patient.-He-put-his-patient-into-1-ESWL-water-fill-tank.jpg?resize=18%2C12&amp;ssl=1 18w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Prof. Christian Chaussy treating the world\u2019s first ESWL patient in 1980 \u2014 the patient is submerged in the original water-filled tank lithotripter.<\/figcaption><\/figure>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"10189\" data-permalink=\"https:\/\/drsoaraweeurology.com\/th\/prof-christian-chaussy-egbert-schmiedt-and-1-eswl-patient-hans-dworsak\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Prof.-Christian-Chaussy-Egbert-Schmiedt-and-1-ESWL-patient-Hans-Dworsak.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Prof. Christian Chaussy, Egbert Schmiedt and First ESWL Patient Hans Dworsak \u2014 Birth of Lithotripsy 1980\" data-image-description=\"\" data-image-caption=\"\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Prof.-Christian-Chaussy-Egbert-Schmiedt-and-1-ESWL-patient-Hans-Dworsak.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Prof.-Christian-Chaussy-Egbert-Schmiedt-and-1-ESWL-patient-Hans-Dworsak.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Historic photograph of Prof. Christian Chaussy, Prof. Egbert Schmiedt and Hans Dworsak \u2014 the world's first patient treated with Extracorporeal Shockwave Lithotripsy (ESWL) in Munich, Germany, February 1980\" class=\"wp-image-10189\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Prof.-Christian-Chaussy-Egbert-Schmiedt-and-1-ESWL-patient-Hans-Dworsak.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Prof.-Christian-Chaussy-Egbert-Schmiedt-and-1-ESWL-patient-Hans-Dworsak.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Prof.-Christian-Chaussy-Egbert-Schmiedt-and-1-ESWL-patient-Hans-Dworsak.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Prof.-Christian-Chaussy-Egbert-Schmiedt-and-1-ESWL-patient-Hans-Dworsak.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Prof.-Christian-Chaussy-Egbert-Schmiedt-and-1-ESWL-patient-Hans-Dworsak.jpg?resize=18%2C12&amp;ssl=1 18w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Prof. Christian Chaussy, Prof. Egbert Schmiedt, and Hans Dworsak \u2014 the world\u2019s first ESWL patient (Munich, February 1980).<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">The Four Generations of ESWL: A Path to Perfection<\/h2>\n\n\n\n<p>The technology has evolved rapidly since 1980. Each generation of machines has aimed to make the treatment <strong>safer, more comfortable, and more accurate<\/strong>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">1. <a href=\"https:\/\/www.americanjournalofsurgery.com\/article\/0002-9610(89)90569-2\/abstract\" target=\"_blank\" rel=\"noreferrer noopener\">The First Generation: The \u201cWater Bath\u201d Era<\/a><\/h3>\n\n\n\n<p>The early machines were massive. To work, the patient had to be submerged in a large tub of water to allow the shockwaves to travel from the generator into the body. The downsides were significant: these machines were incredibly expensive and huge, the focal zone (the area where the energy hits) was wide and therefore less precise, patients required general anesthesia, and they typically required hospitalization.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"10188\" data-permalink=\"https:\/\/drsoaraweeurology.com\/th\/picture-of-1-generation-eswl-thats-very-big-and-need-specialized-urologist-and-technician-only-function-in-high-volumed-excellent-center\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Picture-of-1-generation-ESWL-thats-very-big-and-need-Specialized-urologist-and-Technician-Only-function-in-High-volumed-Excellent-center.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"First-Generation ESWL Machine \u2014 Large Lithotripter for Kidney Stones\" data-image-description=\"\" data-image-caption=\"\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Picture-of-1-generation-ESWL-thats-very-big-and-need-Specialized-urologist-and-Technician-Only-function-in-High-volumed-Excellent-center.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Picture-of-1-generation-ESWL-thats-very-big-and-need-Specialized-urologist-and-Technician-Only-function-in-High-volumed-Excellent-center.jpg?resize=800%2C533&#038;ssl=1\" alt=\"First-generation Extracorporeal Shockwave Lithotripsy (ESWL) machine \u2014 a large, expensive lithotripter requiring specialized urologists and technicians, originally found only in high-volume tertiary kidney stone treatment centers\" class=\"wp-image-10188\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Picture-of-1-generation-ESWL-thats-very-big-and-need-Specialized-urologist-and-Technician-Only-function-in-High-volumed-Excellent-center.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Picture-of-1-generation-ESWL-thats-very-big-and-need-Specialized-urologist-and-Technician-Only-function-in-High-volumed-Excellent-center.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Picture-of-1-generation-ESWL-thats-very-big-and-need-Specialized-urologist-and-Technician-Only-function-in-High-volumed-Excellent-center.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Picture-of-1-generation-ESWL-thats-very-big-and-need-Specialized-urologist-and-Technician-Only-function-in-High-volumed-Excellent-center.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Picture-of-1-generation-ESWL-thats-very-big-and-need-Specialized-urologist-and-Technician-Only-function-in-High-volumed-Excellent-center.jpg?resize=18%2C12&amp;ssl=1 18w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">The first-generation ESWL machine \u2014 a large, expensive lithotripter found only in specialized high-volume kidney stone treatment centers.<\/figcaption><\/figure>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"10187\" data-permalink=\"https:\/\/drsoaraweeurology.com\/th\/picture-described-how-to-facilitate-the-1-eswl-machine\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Picture-described-how-to-facilitate-the-1-ESWL-machine.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"How First-Generation ESWL Machine Works \u2014 Water Bath Lithotripsy Diagram\" data-image-description=\"\" data-image-caption=\"\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Picture-described-how-to-facilitate-the-1-ESWL-machine.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Picture-described-how-to-facilitate-the-1-ESWL-machine.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Technical diagram showing how the first-generation ESWL machine operates \u2014 patient submerged in a water-filled tank with the shockwave generator targeting the kidney stone, the original 1980 lithotripsy setup\" class=\"wp-image-10187\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Picture-described-how-to-facilitate-the-1-ESWL-machine.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Picture-described-how-to-facilitate-the-1-ESWL-machine.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Picture-described-how-to-facilitate-the-1-ESWL-machine.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Picture-described-how-to-facilitate-the-1-ESWL-machine.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Picture-described-how-to-facilitate-the-1-ESWL-machine.jpg?resize=18%2C12&amp;ssl=1 18w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">How the first-generation ESWL machine works \u2014 the patient is submerged in a water-filled tank while the shockwave generator targets the kidney stone.<\/figcaption><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">2. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/1507329\/\" target=\"_blank\" rel=\"noreferrer noopener\">The Second Generation: The \u201cDry\u201d Patient<\/a><\/h3>\n\n\n\n<p>Engineers replaced the giant water tub with a small water-filled cushion or \u201cbellows\u201d pressed against the patient\u2019s skin. The patient stayed dry, and the focal zone became tighter and more accurate. Some treatments could be done under local anesthesia \u2014 but the machines remained large and still required significant radiation exposure for stone targeting.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large is-resized\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"800\" data-attachment-id=\"10185\" data-permalink=\"https:\/\/drsoaraweeurology.com\/th\/this-is-the-picture-of-2-generation-eswl-smaller-machine-and-no-need-for-patient-to-be-placed-in-water-filled-tank\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/This-is-the-picture-of-2-generation-ESWL-Smaller-machine-and-no-need-for-patient-to-be-placed-in-water-filled-tank.jpg?fit=800%2C800&amp;ssl=1\" data-orig-size=\"800,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Second-Generation ESWL Machine \u2014 Dry Patient Lithotripter for Kidney Stones\" data-image-description=\"\" data-image-caption=\"\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/This-is-the-picture-of-2-generation-ESWL-Smaller-machine-and-no-need-for-patient-to-be-placed-in-water-filled-tank.jpg?fit=800%2C800&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/This-is-the-picture-of-2-generation-ESWL-Smaller-machine-and-no-need-for-patient-to-be-placed-in-water-filled-tank.jpg?resize=800%2C800&#038;ssl=1\" alt=\"Second-generation Extracorporeal Shockwave Lithotripsy (ESWL) machine \u2014 smaller, more compact lithotripter using a water-filled cushion against the patient's skin, eliminating the need for a full water-filled tank\" class=\"wp-image-10185\" style=\"width:500px\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/This-is-the-picture-of-2-generation-ESWL-Smaller-machine-and-no-need-for-patient-to-be-placed-in-water-filled-tank.jpg?w=800&amp;ssl=1 800w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/This-is-the-picture-of-2-generation-ESWL-Smaller-machine-and-no-need-for-patient-to-be-placed-in-water-filled-tank.jpg?resize=300%2C300&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/This-is-the-picture-of-2-generation-ESWL-Smaller-machine-and-no-need-for-patient-to-be-placed-in-water-filled-tank.jpg?resize=150%2C150&amp;ssl=1 150w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/This-is-the-picture-of-2-generation-ESWL-Smaller-machine-and-no-need-for-patient-to-be-placed-in-water-filled-tank.jpg?resize=768%2C768&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/This-is-the-picture-of-2-generation-ESWL-Smaller-machine-and-no-need-for-patient-to-be-placed-in-water-filled-tank.jpg?resize=12%2C12&amp;ssl=1 12w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Second-generation ESWL \u2014 a smaller machine using a water-filled cushion against the patient\u2019s skin instead of a full water tank.<\/figcaption><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">3. <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC3319085\/\" target=\"_blank\" rel=\"noreferrer noopener\">The Third Generation: Compact Efficiency<\/a><\/h3>\n\n\n\n<p>These machines became much smaller and more mobile. However, they still relied heavily on X-ray (fluoroscopy) for targeting, meaning patients were exposed to radiation. Furthermore, the patient\u2019s breathing caused the kidney stone to move up and down with each respiration, making it difficult to maintain a 100% \u201chit rate\u201d on the stone.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large is-resized\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"800\" data-attachment-id=\"10186\" data-permalink=\"https:\/\/drsoaraweeurology.com\/th\/this-is-the-picture-of-3-generation-eswl\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/This-is-the-picture-of-3-generation-ESWL.jpg?fit=800%2C800&amp;ssl=1\" data-orig-size=\"800,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Third-Generation ESWL Machine \u2014 Compact Mobile Lithotripter for Kidney Stones\" data-image-description=\"\" data-image-caption=\"\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/This-is-the-picture-of-3-generation-ESWL.jpg?fit=800%2C800&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/This-is-the-picture-of-3-generation-ESWL.jpg?resize=800%2C800&#038;ssl=1\" alt=\"Third-generation Extracorporeal Shockwave Lithotripsy (ESWL) machine \u2014 compact and mobile lithotripter with X-ray fluoroscopy targeting, used in modern kidney stone treatment before the introduction of fourth-generation respiratory tracking systems\" class=\"wp-image-10186\" style=\"width:500px\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/This-is-the-picture-of-3-generation-ESWL.jpg?w=800&amp;ssl=1 800w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/This-is-the-picture-of-3-generation-ESWL.jpg?resize=300%2C300&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/This-is-the-picture-of-3-generation-ESWL.jpg?resize=150%2C150&amp;ssl=1 150w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/This-is-the-picture-of-3-generation-ESWL.jpg?resize=768%2C768&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/This-is-the-picture-of-3-generation-ESWL.jpg?resize=12%2C12&amp;ssl=1 12w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Third-generation ESWL \u2014 a compact, mobile lithotripter with X-ray fluoroscopy targeting.<\/figcaption><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">4. <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC3319085\/\" target=\"_blank\" rel=\"noreferrer noopener\">The Fourth Generation: The Current Standard<\/a><\/h3>\n\n\n\n<p>This represents the technology we utilize today \u2014 a pinnacle of precision and patient safety. The improvements are remarkable:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Auto Stone Localization:<\/strong> The machine finds the stone automatically.<\/li>\n\n\n\n<li><strong>Zero Radiation Exposure:<\/strong> By using advanced ultrasound instead of X-rays, we can see the stone without exposing the patient to radiation.<\/li>\n\n\n\n<li><strong>Respiratory Tracking:<\/strong> The \u201choly grail.\u201d The ultrasound system tracks the stone as it moves with the patient\u2019s breath, ensuring the shockwave hits the target consistently throughout the session.<\/li>\n\n\n\n<li><strong>No Anesthesia Required:<\/strong> Most patients can undergo this treatment without even a painkiller, returning home the same day.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-video alignwide\"><video height=\"1080\" style=\"aspect-ratio: 1920 \/ 1080;\" width=\"1920\" controls src=\"https:\/\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/04\/LITEMED-ESWL-4th-gen-clip.mp4\"><\/video><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">What Determines Success?<\/h2>\n\n\n\n<p>While our 4th-generation technology is highly efficient, the success rate of breaking a stone depends on three critical factors:<\/p>\n\n\n\n<table style=\"width:100%; border-collapse: collapse; margin: 1.5rem 0; font-family: inherit;\">\n  <thead>\n    <tr style=\"background-color: #1a3a6b; color: #ffffff;\">\n      <th style=\"padding: 12px; text-align: left; border: 1px solid #1a3a6b;\">Factor<\/th>\n      <th style=\"padding: 12px; text-align: left; border: 1px solid #1a3a6b;\">Description<\/th>\n    <\/tr>\n  <\/thead>\n  <tbody>\n    <tr style=\"background-color: #f5f7fa;\">\n      <td style=\"padding: 12px; border: 1px solid #d1d5db; vertical-align: top;\"><strong>Stone Hardness<\/strong><\/td>\n      <td style=\"padding: 12px; border: 1px solid #d1d5db; vertical-align: top;\">Not all stones are created equal. We use CT scans to measure the &#8220;Hounsfield Units&#8221; (density) of a stone. The harder the stone, the more shockwaves it may require to fragment.<\/td>\n    <\/tr>\n    <tr>\n      <td style=\"padding: 12px; border: 1px solid #d1d5db; vertical-align: top;\"><strong>Stone Location<\/strong><\/td>\n      <td style=\"padding: 12px; border: 1px solid #d1d5db; vertical-align: top;\">Stones in the kidney or upper ureter generally have higher success rates than those in the very bottom of the kidney (the lower pole), where gravity makes it harder for fragments to wash out naturally.<\/td>\n    <\/tr>\n    <tr style=\"background-color: #f5f7fa;\">\n      <td style=\"padding: 12px; border: 1px solid #d1d5db; vertical-align: top;\"><strong>Stone Size<\/strong><\/td>\n      <td style=\"padding: 12px; border: 1px solid #d1d5db; vertical-align: top;\">Stones under 10 mm have the highest success rates (often 85\u201390% or more). As the stone grows larger than 10 mm, the success rate for a single session may decrease, sometimes requiring a second treatment.<\/td>\n    <\/tr>\n  <\/tbody>\n<\/table>\n\n\n\n<h2 class=\"wp-block-heading\">Final Thoughts<\/h2>\n\n\n\n<p>The evolution of ESWL \u2014 from a wartime observation to a 4th-generation \u201crobotic\u201d tracking system \u2014 is a testament to the power of medical innovation. My presentation in 2018 at Royal Phnom Penh Hospital was, in many ways, a celebration of this progress. Today, we are proud to offer a treatment that is non-invasive, radiation-free, and highly effective \u2014 allowing our patients to return to their lives faster than ever before.<\/p>\n\n\n\n<p>If you are dealing with kidney stones and would like to discuss whether ESWL is the right treatment option for you, Dr. Soarawee Weerasopone offers specialist consultations in kidney stone treatment at Bangkok Hospital Headquarters. <a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" target=\"_blank\" rel=\"noreferrer noopener\">Book a Consultation<\/a>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Frequently Asked Questions About ESWL<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">What is ESWL and how does it break kidney stones?<\/h3>\n\n\n\n<p>ESWL (Extracorporeal Shockwave Lithotripsy) uses focused shockwaves generated outside the body to break kidney stones into small fragments. The shockwaves pass through the skin and tissue, concentrating their energy on the stone to fracture it into pieces small enough to be passed naturally in the urine.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Is ESWL painful or does it require anesthesia?<\/h3>\n\n\n\n<p>With modern 4th-generation ESWL machines, most patients can undergo treatment without anesthesia or even painkillers. The procedure is non-invasive and well tolerated, allowing patients to return home the same day.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">What size of kidney stone is best treated with ESWL?<\/h3>\n\n\n\n<p>Stones under 10 mm have the highest success rates with ESWL \u2014 often 85\u201390% or higher in a single session. Stones larger than 10 mm may still respond to ESWL but sometimes require a second treatment session for complete clearance.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Does modern ESWL still use X-ray radiation?<\/h3>\n\n\n\n<p>Fourth-generation ESWL machines use advanced ultrasound for stone localization, eliminating the need for X-ray radiation during the procedure. This makes the treatment safer for patients, especially those who may need repeat sessions.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">What factors affect the success rate of ESWL?<\/h3>\n\n\n\n<p>Three main factors determine ESWL success: stone hardness (measured in Hounsfield Units on CT scan), stone location (upper kidney and ureter respond better than lower pole stones), and stone size (smaller stones have higher success rates).<\/p>\n\n\n\n<script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@type\": \"FAQPage\",\n  \"mainEntity\": [\n    {\n      \"@type\": \"Question\",\n      \"name\": \"What is ESWL and how does it break kidney stones?\",\n      \"acceptedAnswer\": {\n        \"@type\": \"Answer\",\n        \"text\": \"ESWL (Extracorporeal Shockwave Lithotripsy) uses focused shockwaves generated outside the body to break kidney stones into small fragments. The shockwaves pass through the skin and tissue, concentrating their energy on the stone to fracture it into pieces small enough to be passed naturally in the urine.\"\n      }\n    },\n    {\n      \"@type\": \"Question\",\n      \"name\": \"Is ESWL painful or does it require anesthesia?\",\n      \"acceptedAnswer\": {\n        \"@type\": \"Answer\",\n        \"text\": \"With modern 4th-generation ESWL machines, most patients can undergo treatment without anesthesia or even painkillers. The procedure is non-invasive and well tolerated, allowing patients to return home the same day.\"\n      }\n    },\n    {\n      \"@type\": \"Question\",\n      \"name\": \"What size of kidney stone is best treated with ESWL?\",\n      \"acceptedAnswer\": {\n        \"@type\": \"Answer\",\n        \"text\": \"Stones under 10 mm have the highest success rates with ESWL - often 85-90% or higher in a single session. Stones larger than 10 mm may still respond to ESWL but sometimes require a second treatment session for complete clearance.\"\n      }\n    },\n    {\n      \"@type\": \"Question\",\n      \"name\": \"Does modern ESWL still use X-ray radiation?\",\n      \"acceptedAnswer\": {\n        \"@type\": \"Answer\",\n        \"text\": \"Fourth-generation ESWL machines use advanced ultrasound for stone localization, eliminating the need for X-ray radiation during the procedure. This makes the treatment safer for patients, especially those who may need repeat sessions.\"\n      }\n    },\n    {\n      \"@type\": \"Question\",\n      \"name\": \"What factors affect the success rate of ESWL?\",\n      \"acceptedAnswer\": {\n        \"@type\": \"Answer\",\n        \"text\": \"Three main factors determine ESWL success: stone hardness (measured in Hounsfield Units on CT scan), stone location (upper kidney and ureter respond better than lower pole stones), and stone size (smaller stones have higher success rates).\"\n      }\n    }\n  ]\n}\n<\/script>\n\n\n\n<p><strong>Disclaimer:<\/strong> This content is medically written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters. It is intended for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before starting any medical treatment.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Soarawee Weerasopone, Urologist Bangkok hospital Headquarter, Bangkok Samitivej Sriracha hospital, Chonburi Welcome to a journey through the history and science of one of the most transformative technologies in modern urology: Extracorporeal Shockwave Lithotripsy (ESWL). As a board-certified urologist specializing in kidney stone treatment, I want to share with you how a wartime observation evolved into [&hellip;]<\/p>\n","protected":false},"author":185281453,"featured_media":10239,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"Dr. Soarawee, urologist at Bangkok Hospital, traces the evolution of Extracorporeal Shockwave Lithotripsy (ESWL) from WWII discoveries to today's radiation-free 4th-generation kidney stone treatment.","jetpack_seo_html_title":"The Evolution of ESWL: From WWII to 4th-Generation Lithotripsy | Dr. Soarawee","jetpack_seo_noindex":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"_wpas_customize_per_network":false,"jetpack_post_was_ever_published":false},"categories":[1],"tags":[],"class_list":["post-10181","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/The-Evolution-of-Stone-Treatment.jpg?fit=1200%2C630&ssl=1","jetpack_likes_enabled":false,"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/pgZdrK-2Ed","_links":{"self":[{"href":"https:\/\/drsoaraweeurology.com\/th\/wp-json\/wp\/v2\/posts\/10181","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drsoaraweeurology.com\/th\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drsoaraweeurology.com\/th\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/th\/wp-json\/wp\/v2\/users\/185281453"}],"replies":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/th\/wp-json\/wp\/v2\/comments?post=10181"}],"version-history":[{"count":9,"href":"https:\/\/drsoaraweeurology.com\/th\/wp-json\/wp\/v2\/posts\/10181\/revisions"}],"predecessor-version":[{"id":10261,"href":"https:\/\/drsoaraweeurology.com\/th\/wp-json\/wp\/v2\/posts\/10181\/revisions\/10261"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/th\/wp-json\/wp\/v2\/media\/10239"}],"wp:attachment":[{"href":"https:\/\/drsoaraweeurology.com\/th\/wp-json\/wp\/v2\/media?parent=10181"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/th\/wp-json\/wp\/v2\/categories?post=10181"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/th\/wp-json\/wp\/v2\/tags?post=10181"}],"curies":[{"name":"\u0e14\u0e31\u0e1a\u0e40\u0e1a\u0e34\u0e25\u0e22\u0e39\u0e1e\u0e35","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}