Extracorporeal Shock Wave Lithotripsy for Kidney Stones
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Extracorporeal Shock Wave Lithotripsy for Kidney Stones

(Lithotripsy for Kidney Stones)

En Español (Spanish Version)

Definition

Extracorporeal shock wave lithotripsy is a nonsurgical treatment for stones in the kidney and ureter. It uses high energy shock waves to break kidney stones into tiny pieces. The pieces can then be passed with the urine.

Kidney Stones

Kidney Stones

© 2008 Nucleus Medical Art, Inc.

Parts of the Body Involved

  • Kidney
  • Ureter

Reasons for Procedure

Lithotripsy is used to remove a kidney stone that:

  • Is too large to pass
  • Causes constant pain
  • Blocks the flow of urine
  • Causes an ongoing urinary tract infection
  • Damages kidney tissue
  • Causes bleeding
  • Grows larger

Risk Factors for Complications During the Procedure

A risk factor is something that increases your chance of having complications during your procedure. Risk factors this procedure include:

  • Allergy to anesthesia
  • Regular use of aspirin or other drugs that may affect blood-clotting
  • Obesity
  • Skeletal deformities
  • Pregnancy (contraindicated)
  • Presence of a pacemaker
  • Presence of a dilated aorta (aneurysm)

What to Expect

Prior to Procedure

Your doctor will likely do the following:

  • Physical exam
  • X-ray
  • Blood and urine tests
  • IVP (intravenous pyelogram)—an x-ray of the urinary system taken after the injection of dye
  • Spiral CT scan—a type of x-ray that uses a computer to make pictures of structures inside the body
  • MRI scan—a test that uses magnetic waves to make pictures of structures inside the body
  • Instruct you to stop certain medications before surgery to avoid abnormal bleeding (eg, aspirin and other blood-thinning agents)

Anesthesia

Heavy sedation or general anesthesia is used to help you remain still and avoid discomfort.

Description of the Procedure

You are placed on a table attached to the lithotripsy equipment. The area being treated will lie on top of a soft cushion or membrane through which the waves pass. Your doctor uses x-rays or ultrasound to locate the stone, then positions your body to target the stone. One to three thousand shock waves are passed through the stones, until they are crushed into pieces as small as grains of sand.

After Procedure

You will be moved to a recovery area. You will be encouraged to drink fluids and may be given fluids through an intravenous (IV) line.

How Long Will It Take?

45 to 60 minutes

Will It Hurt?

Anesthesia prevents pain during the procedure. Pain and discomfort after the procedure can be managed by oral pain medication. There will be some pain and discomfort afterward from the passage of broken stones, and some bruising on the area treated.

Possible Complications

  • Blood in the urine
  • Bruising in the back or abdomen
  • Pain as the stone fragments pass
  • Need for additional treatments

Average Hospital Stay

Typically, no hospital stay is needed.

Postoperative Care

You will be instructed to drink plenty of water in the weeks after the procedure to help the stone pieces pass. You will be able to move almost immediately after the procedure. You will likely be able to resume daily activities within 1-2 days. You may be prescribed oral pain medication to help manage pain and discomfort.

Outcome

About 70% to 90% of people who have lithotripsy for kidney stones are free of stones within three months of treatment. Patients with stones in the kidney and upper ureter have the highest success with treatment. There may be fragments that are too large to pass persist after the procedure. They can be treated with lithotripsy again.

Call Your Doctor If Any of the Following Occurs

It is essential for you to monitor your recovery once you leave the hospital. That way, you can alert your doctor to any problems immediately. If any of the following occur, call your doctor:

  • Excessive urge to urinate or inability to urinate
  • Excessive blood in the urine
  • Pain between the ribs and groin as stones pass
  • Signs of infection such as fever and chills
  • Extreme pain

RESOURCES:

American Urologic Association
http://www.urologyhealth.org

National Kidney and Urologic Diseases Information Clearinghouse
http://kidney.niddk.nih.gov

National Kidney Foundation
http://www.kidney.org

CANADIAN RESOURCES:

Canadian Urological Association
http://www.cua.org/

The Kidney Foundation of Canada: Northern Alberta and the Territories Branch
http://www.kidney.ab.ca

References:

Surgical management of stones. American Urological Association website. Available at: http://urologyhealth.org. Accessed June 24, 2008.

Kidney stones in adults. National Kidney and Urologic Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/stonesadult. Accessed June 24, 2008.

Lithotripsy. National Kidney Foundation website. Available at: http://www.kidney.org/atoz/atozPrint.cfm?id=87. Accessed June 24, 2008.

Wash PC, Vaughan ED, Wein AJ, Kavoussi LR, Novick A, Partin AW, et al. Campbell’s Urology. 8th ed. Saunders;2002.



Last reviewed June 2008 by Adrienne Carmack, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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