Home | Procedures | Lithotripsy
By Dr Raviteja Ramisetty
Consultant Urologist
Published on 03 October 2022

Article Context

  1. Overview
  2. Procedure
  3. Benefits and risks
  4. Care at Medicover
  5. Frequently Asked Questions

Overview

Lithotripsy is a procedure for removing kidney stones too large to pass through the urinary tract. Lithotripsy treats kidney stones by sending focused ultrasonic energy or shock waves directly to the stones after they have been detected using fluoroscopy (X-rays to obtain real-time moving images) or ultrasound (high-frequency sound waves). The shock waves disintegrate a large stone into smaller pieces of stones that can pass through the urinary system. It allows people with specific urinary stones to avoid invasive surgical stone removal.

Extracorporeal shock wave lithotripsy (ESWL) is the most common type of lithotripsy. "Extracorporeal" refers to the outside of the body. Your doctor must be able to view the stones under X-ray or ultrasound to aim the waves.

Kidney stones cause pain, bleeding, damage to the kidney and urinary tract infections.

When substances excreted by the kidneys remain in the urinary tract, they can crystallize and harden into kidney stones. The size, exact location, and consistency of the stone all influence the management and treatment of kidney stones. Drug or medication therapy, dietary and lifestyle changes are initially advised based on the patient's conditions. If the stone has not yet dissolved, removal surgery is performed to keep the kidney function from deteriorating and avoid further complications.

Procedure

Before the Procedure

  • Before undergoing the procedure, your doctor will take a complete medical history and perform a thorough physical examination.
  • Blood tests or other diagnostic tests such as EKG, CBC, urine culture, urinalysis and blood coagulation profile (PT/PTT) are required.
  • Depending on the type of anesthesia or sedation used, fasting before the procedure may be advised. You will be informed about how many hours you should fast before the procedure.
  • If you are pregnant or planning to conceive, you should notify your doctor.
  • Inform your doctor if you are sensitive or allergic to any medications, latex, tape, or anesthetic agents.
  • Inform your doctor about any medications and herbal supplements which you are using.
  • If you have any history of bleeding disorders or are taking blood-thinning medications, notify your doctor. You may be advised to stop taking these medications before the procedure.
  • Prior to the procedure, you may be given a sedative to help you relax.

During the Procedure

  • You are provided with a gown to wear.
  • An intravenous (IV) line will be inserted into your arm or hand.
  • You may be given a sedative or anesthetic to keep you calm and pain-free during the procedure.
  • You are positioned on a water-filled cushion or rarely immersed in a water-filled tub after the sedation has taken effect.
  • The stone will be located using ultrasound or fluoroscopy and you will be positioned for the most direct access to the stone.
  • You may feel a tapping sensation on your skin if you are awake during the procedure.
  • The lithotripter machine which is used to deliver shock waves is positioned to be in contact with the flank of the patient towards the stone side.
  • A series of up to 2,000 shock waves are delivered to fragment the stone.
  • ESWL is performed under X-Ray guidance to accurately target the stone in efforts to maximize stone fragmentation while minimizing adjacent organ injury.
  • The stones will be monitored by ultrasound or fluoroscopy during the procedure.
  • A stent is a tube that is inserted into your kidney from your back or bladder. This tube will drain urine from the kidney until all of the stone fragments have passed out of your body.
  • The procedure will be completed once the stone fragments are small enough to pass through the urinary system.

After the Procedure

  • The staff will take you to the recovery room following surgery for observation. You will be discharged home when your pulse, blood pressure, and breathing have stabilized.
  • You can resume your regular diet and daily activities once you are stable.
  • You will be instructed to drink more fluids to dilute the urine and alleviate the discomfort caused by passing stone fragments.
  • Following the procedure, you may notice blood in your urine for a few days or longer and it is entirely normal.
  • Bruising on the back or abdomen may occur.
  • Take antibiotics and painkillers as prescribed by your doctor. Make sure you take the medication exactly as directed.
  • You may be asked to collect your urine so that any remaining stones or fragments of stones can be analyzed in the lab.
  • A follow-up appointment will be scheduled. If a stent was used during the procedure, it might be removed.

Benefits

  • Treatment for kidney stones without surgery.
  • Reduction of complications, hospital stay, and cost.
  • Faster recovery.

Risks

  • Bleeding near the kidney
  • Infection
  • Stone fragments left that may require additional lithotripsy
  • Stone fragments obstructing the urinary tract

Care at Medicover

We have the most eminent team of Urologists working together to provide the most precise diagnosis and treatment for kidney stones. To treat various types of kidney diseases and ailments, our highly skilled team employs cutting-edge medical equipment, diagnostic procedures, and technologies. We use extracorporeal shockwave lithotripsy, laser lithotripsy and other advanced minimally invasive procedures for kidney stones that are both safe and painless. We also use a multidisciplinary approach to provide patients with all-around care and to address all of their medical needs at once, resulting in a faster and sustained recovery.

Frequently Asked Questions:

Lithotripsy involves breaking up the stones present in the kidney into smaller fragments using suitable methods. Once broken up, these stones can be passed out of the body through urine.

Patients have to be admitted to the hospital for this procedure. A standard lithotripsy procedure is completed within 45 minutes to an hour.

Lithotripsy is generally performed by a urologist.

Shock wave lithotripsy is a procedure that can be used to treat kidney stones. It uses high-energy waves to break the stone into tiny fragments that can then be passed out of the body.

Large kidney stones are those that are 5 mm or larger in size. Because of their size, they may have difficulty passing through the urinary tract.

References