How anesthesia-free stone treatment may shift urology practice

In this video, urologist Mathew D. Sorensen, MD, MS, FACS, discusses the clinical performance and practice-changing potential of Break Wave technology for the treatment of kidney and ureteral stones.

Based on published data to date, Sorensen believes Break Wave is highly competitive with existing modalities such as shock wave lithotripsy (SWL), ureteroscopy (URS), and even conservative management. He notes that most studies so far have evaluated Break Wave as a standalone therapy, and outcomes are expected to improve further as it is paired with ultrasonic propulsion and stone-clearing technologies. Current efficacy for non-obstructing renal stones appears comparable to SWL, whereas ureteral stone treatment demonstrates stone-free rates similar to URS—approaching 89% to 90%.

Beyond clinical outcomes, Sorensen emphasizes the real-world implications of performing lithotripsy without anesthesia. Because Break Wave uses lower pressure levels, patient discomfort is minimal, allowing treatments to be performed without sedation. This not only improves patient tolerance but also enables unprecedented flexibility in where care is delivered. Procedures could be performed in outpatient clinics, emergency departments, ambulatory surgery centers, or other non-operating room settings, reducing dependence on anesthesia services and operating room time.

An unexpected benefit, Sorensen adds, is active patient participation during treatment. Awake patients can visualize the stone and kidney on a monitor and often learn to adjust their breathing to keep the stone within the focal zone, improving treatment efficiency. From a systems perspective, Break Wave could significantly reshape stone care pathways—shortening or eliminating trials of medical expulsive therapy, enabling earlier intervention, and supporting preemptive treatment of small, asymptomatic stones that are currently observed. Ultimately, Sorensen anticipates that Break Wave may become a first-line therapy for many stone patients while shifting substantial resources out of the operating room.

DISCLOSURE: Sorensen is a member of the scientific advisory board for and has an equity interest in SonoMotion.