Part 1 Of 2: Treating Kidney Stones
How Will I Feel After Surgery
You may still experience pain after laser surgery. If you have a stent between the kidney and ureter, most pain will likely come from the stent because it can rub on the kidney or bladder. It also can make you feel like you have to urinate, and it may cause some blood in the urine. Men may have pain in the penis or testicles as well.
Your doctor will prescribe medications after surgery. Generally, these may include an antibiotic to prevent infection, pain medication, and perhaps something to treat bladder spasms and burning with urination.
Drink plenty of water to lubricate the stent and encourage any small stones to move out of the kidney. You will likely feel a more frequent urge to urinate, so you may want to stay close to a bathroom.
You can resume normal activities the next day, or as soon as you feel comfortable. Skip high-intensity workouts until after your stent is removed. Some pain medications restrict activities like driving, so check the warnings on the label. Your doctor will have additional recommendations for you to follow.
How Successful Is Extracorporeal Shock Wave Lithotripsy
In those patients who are thought to be good candidates for this treatment, about 70 to 90 percent are found to be free of stones within three months of treatment. The highest success rates seem to be in those patients with mobile stones that are located in the upper portions of the urinary tract . After treatment, some patients may still have stone fragments that are too large to be passed. These can be treated again if symptoms persist.
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What Will Happen After I Leave The Hospital
After treatment, you will have blood in your urine and possibly abdominal pain or aching for several days. Other people experience a severe cramping pain as shattered stone fragments make their way out of the body. Oral pain medication and drinking lots of water will help relieve symptoms.
Sometimes, the stone is not completely broken up, or big pieces remain and additional treatments may be needed.
Rarely, more serious problems occur, such as bleeding near the kidney that might require a blood transfusion, damage to the area around the stone, or pieces of the stone blocking the flow of urine.
When Is Shock Wave Lithotripsy Not Recommended To Treat Kidney Stones
Your provider needs to know a stones exact location. Typically a CT scan is performed to identify your stone location and size. Sometimes an X-ray and/or ultrasound can be used as well.
You may not be a candidate for shock wave lithotripsy if you have:
- Hard stones: Kidney stones made up of certain substances may be more difficult to break up with shock wave lithotripsy.
- Pregnancy: Women who are or could be pregnant should not have lithotripsy. The shockwaves may harm an unborn child.
- Infected kidney stone: An infected kidney stone that is stuck in the ureter and causing fevers or chills is a medical emergency and should not be treated with shockwave lithotripsy.
- Special medical needs: Shockwave lithotripsy should not be used in medical conditions that result in increased risk of bleeding, such as use of blood thinners, due to increased risk of severe bleeding from the kidney.
- Very large kidney stones: Shock wave lithotripsy works best on small kidney stones. Your provider may recommend another treatment for kidney stones over 1-2 centimeters in diameter.
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Can All Kidney Stone Patients Have This Kind Of Treatment
No. The size, number, location and composition of the stones are factors that must be taken into account when exploring treatment options. Patient size may limit use of the water bath method, but patients of many sizes can be treated with the water cushion method.
Also the stones must be clearly viewed by the x-ray monitor so the shock waves can be targeted accurately. If anatomical abnormalities prevent this, other methods of stone removal may have to be considered. Through examination, x-ray and other tests, the doctor can decide whether this is the best treatment for the patient. In some cases, extracorporeal shock wave lithotripsy may be combined with other forms of treatment.
How To Get Rid Of Kidney Stones
This article was co-authored by Chris M. Matsko, MD. Dr. Chris M. Matsko is a retired physician based in Pittsburgh, Pennsylvania. With over 25 years of medical research experience, Dr. Matsko was awarded the Pittsburgh Cornell University Leadership Award for Excellence. He holds a BS in Nutritional Science from Cornell University and an MD from the Temple University School of Medicine in 2007. Dr. Matsko earned a Research Writing Certification from the American Medical Writers Association in 2016 and a Medical Writing & Editing Certification from the University of Chicago in 2017.There are 27 references cited in this article, which can be found at the bottom of the page.wikiHow marks an article as reader-approved once it receives enough positive feedback. This article has 18 testimonials from our readers, earning it our reader-approved status. This article has been viewed 1,703,618 times.
Kidney stones, also known as renal lithiasis or calculi, occur when small mineral crystals form in the kidney. Kidney stones are painful, but you may be able to treat them yourself. However if the pain persists, make sure to see your doctor
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What If Shock Wave Lithotripsy Doesnt Work
In some cases, shock wave lithotripsy doesnt break up a stone enough for all pieces to pass on their own. If that happens, you may need another procedure.
Depending on your situation, your provider may recommend a second shock wave lithotripsy. Or your provider may suggest clearing any remaining stones through a minimally invasive procedure called ureteroscopy. Talk to your healthcare provider about the different types of kidney stone treatments.
Extracorporeal Shock Wave Lithotripsy
Extracorporeal is the most common and widely used form of lithotripsy. During this non-invasive procedure, a fluoroscopic x-ray imaging system or an ultrasound imaging system is first used to pinpoint the stones’ location. A water-filled cushion or “coupling device” is either placed on the patients abdomen or, more often, under his back at kidney level, then high-energy shock waves generated outside the body are directed through the cushion, fragmenting the stones into pieces small enough to pass during urination.
What to Expect with ESWL
The procedure typically takes between 45 and 60 minutes and can cause some pain, so patients are typically given either local or general anesthesia. Depending on the type of anesthesia used, patients may feel the shock waves, which some liken to a tapping sensation or an elastic band reverberating off of the skin.
Following the ESWL Procedure
After the procedure is over, patients can expect to remain in recovery for up to two hours. Provided there are no complications, many will be able to go home the same day.
Because there is a risk of infection from bacteria released from the stones, it is common for physicians to prescribe a course of antibiotics. Doctors also recommend that people recovering from ESWL drink plenty of water to help lubricate the stones as they pass and lessen discomfort. Following treatment, it is normal to have blood in the urine as well as some abdominal pain.
Is ESWL Right for You?
How Well Does ESWL Work?
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Risks And Side Effects
People often experience bruising and soreness after shock wave lithotripsy.
Fever or chills may occur after ureteroscopy and shock wave lithotripsy. These may indicate an infection, so a person should speak with a doctor if they experience fever or chills.
Heavy bleeding after lithotripsy is uncommon.
If stone fragments get stuck, there may be a blockage in the ureter. If this is the case, a doctor may perform an additional procedure with a ureteroscope to remove the fragments.
Prolonged pain may also indicate a blockage. If a person has severe pain or does not get relief from taking pain medications, they should contact a doctor.
What Happens During A Ureteroscopy
Once the anesthesia takes effect and youâre asleep, your urologist will insert the tip of the ureteroscope into your urethra .
Once the ureteroscope is in the bladder, your urologist releases a sterile solution through the tip of the scope. This fills the bladder so its walls can be seen more clearly. They then gently guideÂ;the scope into a ureter. If there is a concern about a kidney, the scope can be moved all the way up into that organ.
It may take up to 30 minutes for them to observe your urinary tract. If a procedure is done to remove or break up a stone, or to take a tissue sample for a biopsy, the ureteroscopy may take longer.
A ureteroscopy that uses a laser to break up small kidney stones may take about 90 minutes. The type of laser used with the ureteroscope is called a âHolmium laser.â A similar procedure uses a tiny basket at the end of the scope to grab and remove a stone.
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Key Points To Remember
- The smaller a stone is, the more likely it is to pass on its own.
- The type of treatment you need depends on how big the stone is and how likely it is to pass on its own. If the stone will probably pass and you can control your pain with medicine, home treatment may be enough.
- If you can’t control your pain with medicine, or if the stone is blocking the urine flow, your best choice may be lithotripsy. Lithotripsy may work best for kidney stones that are still in the kidney or in the part of the ureter close to the kidney.
- You have options other than this procedure, but it is the most commonly used method because it works well and does not require surgery.
- You will probably not have lithotripsy if you are pregnant or have a bleeding disorder, kidney infection, urinary tract infection, kidney cancer, or some other kidney problems.
What Are The Advantages And Disadvantages Of This Treatment
The main advantage of this treatment is that it treats kidney stones without an incision. As a result, hospital stays and recovery time are reduced.
But, while SWL can work, it doesn’t always work. After SWL, about 5O% of people will be stone free within a month. In others, stone fragments of various sizes remain. Sometimes a repeat procedure is needed.
SWL has the potential to cause kidney injury. Whether or not SWL causes or leads to the development of high blood pressure and diabetes remains controversial. These possibilities are still being studied. You should ask your doctor about risks and benefits of SWL in your situation.
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What Other Treatment Choices Are Available
About 90 percent of stones pass through the urinary system without treatment. In cases where this does not occur, treatment to remove stones may be needed. Some stones may be dissolved by medicines. In other cases, one of the following methods of stone removal may be needed:
Percutaneous Stone RemovalWhen stones are quite large or in a location that does not allow effective lithotripsy, a technique called percutaneous stone removal may be used. In this method, the surgeon makes a small incision in the back and creates a tunnel directly into the kidney. A tube is inserted and the stone is removed through this tube.
Ureteroscopic Stone RemovalFor stones found in the lower part of the urinary tract, the doctor may pass a ureteroscope up into the bladder and ureter. A basket-like device may be passed through the tube to grasp and withdraw the stone.
What Are Kidney Stones
Kidney stones are pieces of minerals that form in the kidneys. They form when the normal balance of water, salts, minerals, and other substances found in your urine changes. The type of kidney stones you get depends on how this balance changes. Most kidney stones are calcium-typethey form when the calcium levels in your urine change.
Kidney stones may stay in the kidney or travel out of the body through the urinary tract.
When moving through the urinary tract, a stone may cause great pain and other symptoms. Kidney stones can cause long-term damage to the urinary tract if they keep growing or if they block the flow of urine from the kidneys.
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What Are Kidney Stones And How Are They Treated
Kidney stones are hard, rock-like accumulations of salts and minerals. They typically form in the kidneys, some in the bladder, but may be found anywhere in the urinary tract.
Most people with kidney stones know they have them because the stones cause severe pain as they work their way through the urinary system. Small stones may pass on their own. Larger stones may require medical or surgical intervention to prevent complications.
Anyone experiencing a kidney stone should contact a doctor.
What Matters Most To You
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have lithotripsy for kidney stones
Reasons to wait for the stone to pass on its own
I want to increase the chance of my stone passing sooner.
I’m not concerned with how soon my stone passes.
I’m worried about the pain from passing a kidney stone.
I can use medicine to control the pain.
I’m not bothered by having a medical procedure.
I don’t want to have a medical procedure.
I know that the procedure has risks, but I’m not concerned about them.
I am concerned about the risks of the procedure.
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Reasons For The Procedure
The primary advantage of lithotripsy is that it is completely non-invasive.
Lithotripsy is well suited to patients with small kidney stones that can be easily seen by x-ray.
When kidney stones become too large to pass through the urinary tract, they may cause severe pain and may also block the flow of urine. An infection may develop. Lithotripsy may be performed to treat certain types of kidney stones in certain locations within the urinary tract.
There may be other reasons for your doctor to recommend lithotripsy.
What About Stones In The Ureter
Most small ureteral stones will pass on their own. lf they don’t pass, then another intervention is usually done. Ureteral stones that occur near the kidney are usually treated by SWL with or without moving the stone to a better spot. Ureteral stones that occur lower may also be treated with SWL, but they usually require ureteroscopy especially if they are large .
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Treating Small Kidney Stones
Small kidney stones may cause pain until you pass them, which usually takes 1 or 2 days.
A GP may recommend a non-steroidal anti-inflammatory drug to help with pain.
To ease your symptoms, a GP might also recommend:
- drinking plenty of fluids throughout the day
- anti-sickness medicine
You might be advised to drink up to 3 litres of fluid throughout the day, every day, until the stones have cleared.
To help your stones pass:
- drink water, but drinks like tea and coffee also count
- add fresh lemon juice to your water
- avoid fizzy drinks
- do not eat too much salt
Make sure you’re drinking enough fluid. If your pee is dark, it means you’re not drinking enough. Your pee should be pale in colour.
You may be advised to continue drinking this much fluid to prevent new stones forming.
If your kidney stones are causing severe pain, your GP may send you to hospital for tests and treatment.
What Is Extracorporeal Shock Wave Lithotripsy
Extracorporeal shock wave lithotripsy is a technique for treating stones in the kidney and ureter that does not require surgery. Instead, high energy shock waves are passed through the body and used to break stones into pieces as small as grains of sand. Because of their small size, these pieces can pass from the body along with the urine.
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Ureteroscopy For Kidney Stones Minimally Invasive Treatment
Ureteroscopy is the process of a urologist using a small scope to look inside the ureter . The scope, called a ureteroscope, is about the size of a cocktail straw and allows stones, lesions, or blockages to be assessed and treated.
Our urologists perform ureteroscopy in an operating room under anesthesia and the procedure typically takes 30-45 minutes.
In some cases, a stent is temporarily placed in the ureter to help kidney stone fragments pass more easily. The stent is a small tube that enlarges the ureter temporarily and may be placed before or at the time of ureteroscopy. Stents are typically removed after 1 week during an office visit.
After the procedure, most kidney stone patients have immediate relief from their discomfort. The stent may be slightly uncomfortable or create a feeling of having to urinate often. There usually is blood in the urine for a few days. The patient may feel sore for a few days, but can return quickly to regular activities.