Study of an Enhanced Lithotripsy System (ELS) in the Treatment of Urinary Stone Disease

1. Male or female aged ≥ 18 years
2. Provides written informed consent
3. Understands and accepts the study requirements

4. One urinary stone eligible for treatment (minimum) that is:

   1. apparent on a computed tomography (CT) scan within 14 days prior to study enrollment
   2. located within the renal pelvis or ureter
   3. is ≥ 3 mm in at least one dimension and ≤ 10 mm in maximum
   4. less than or equal to 10mm in maximum dimension and has an area less than 56mm2 as estimated by pre-procedure CT dimension as estimated by pre- procedure CT

5. Participants with two or more stones in one or both kidneys are admissible and must meet the following inclusion criteria:

   1. Number of stones (≥ 3 mm) present on treated side is 2 or less
   2. Untreated stones must not be anticipated to require treatment within 30 days of enrollment, as determined by the investigator

Exclusion Criteria:

1. Age less than 18 years of age or over 75 years of age
2. Diagnosis of radiolucent stones
3. History of cystinuria
4. Urine pH below 5.5
5. Current untreated urinary tract infection
6. Pregnancy
7. Vulnerable individuals (mentally disabled, physically disabled, prisoner, etc.)
8. Enrollment in another research study or previous participation within 30 days of enrollment.
9. Participant has planned general anesthesia during index procedure with American Society of Anesthesiologists (ASA) physical classification level of 3 or greater
10. Known sensitivity to possible medications used before, during, or after the ELS procedure, including but not limited to the following: sedative agents, general anaesthetics, topical anaesthetics, and opioid analgesics
11. Coagulation abnormality or taking prescription anticoagulants that cannot be stopped during treatment. Aspirin usage will be discontinued at least 7 days prior to enrollment at the discretion of the attending physician
12. Mobility issues - unable to comfortably lie still for up to 120 minutes or unable to roll from back to side
13. Known hypersensitivity to conductivity gel
14. Body mass index (BMI) ≥ 35 unless anticipated skin to stone distance (anticipated distance from site of ELS treatment head to stone per pre-operative CT) is \<135mm
15. Implanted spinal cord neurostimulator intrathecal pump or any device that may interfere with energy transmission
16. Participant has open wounds, lesions, dermatitis, or ischemic tissues in the treatment area
17. Participant has had a major surgery that removed tissue around the spinal cord (e.g. a laminectomy) within the treatment area
18. Participant will undergo treatment of a stone located in the distal ureter and has previous hernia repair or surgical mesh implanted in the inguinal/hypogastric regions