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What Is Lithotripsy For Kidney Stones

What To Expect Afterwards

How extracorporeal shockwave lithotripsy is used to treat kidney stones

You should be able to go home a couple of hours after the procedure. If youve had a sedative, you might feel a bit groggy for a while. Because of this, its safest not to drive, drink alcohol, operate machinery or make any important decisions for 24 hours after sedation. Make sure someone can take you home.

Before you leave, your doctor or nurse will give you some advice about your recovery and information about follow-up appointments. You may be prescribed painkillers to ease any pain or discomfort, and antibiotics to prevent an infection.

What To Expect After Lithotripsy For Kidney Stones

As with any medical procedure, there can be risks and aftereffects. Some of these can include:

  • Frequent urination.
  • Pain or discomfort as stone fragments pass.
  • Additional treatment if stones arent broken down enough to pass.
  • Infection if stones become lodged.
  • Blood in the urine.
  • Tissue damage from shock waves.

Lithotripsy patients should contact their urologist if they experience persistent or severe symptoms following their procedure.

If you have a history of kidney stones, contact Urology Austin to schedule an appointment.

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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Percutaneous Nephrolithotomy Or Percutaneous Nephrolithotripsy

If your stone is large or lithotripsy doesn’t break it up enough, this surgery is an option. PCNL uses a small tube to reach the stone and break it up with high-frequency sound waves.

You will be given something so that you wonât be awake during this surgery. Your surgeon will make a small cut in your back or side and place a thin scope into the hole.

The surgery can be done in one of two ways:

Nephrolithotomy: Your surgeon removes the stone through a tube

Nephrolithotripsy: Your surgeon uses sound waves or a laser to break up the stone and then vacuums up the pieces with a suction machine.

The surgery takes 20 to 45 minutes. You’ll typically have to stay in the hospital for a day or two afterward. Usually, a stent will have to stay in your kidney for a few days to help urine drain.

Your doctor might do an X-ray or ultrasound a few weeks later to see whether any parts of the stone are left. They might also send the stone fragments to a lab to find out what they’re made of.

Risks from this surgery include:

  • Infection
  • Damage to the bladder, bowel, ureter, kidney, or liver

Southern Cross Medical Library

Lithotripsy for the Treatment of Kidney Stones

The purpose of the Southern Cross Medical Library is to provide information of a general nature to help you better understand certain medical conditions. Always seek specific medical advice for treatment appropriate to you. This information is not intended to relate specifically to insurance or healthcare services provided by Southern Cross. For more articles go to the Medical Library index page.

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When Is Lithotripsy Used

Kidney stones are usually small enough to pass through the urinary tract along with urine. In some cases, the stones are too large to pass on their own. Lithotripsy is normally used when:

Stones are too large to pass Stones are blocking the flow of urine. Stones are causing bleeding or infection Pain medication isnt effective when trying to pass stones

Some stones may be too large to treat with shockwave lithotripsy. The size, shape, location, and the number of stones will all be evaluated to see if this procedure is appropriate.

Your doctor may advise alternate treatment if you are pregnant, weigh over 300 pounds, have a pacemaker, kidney cancer, kidney infection, or on medications for cardiac conditions.

What Are The Pros And Cons Of Lithotripsy For Kidney Stones

Lithotripsy is a type of medical procedure that uses shock waves to help break up large kidney stones into smaller fragments that can then pass on their own. This type of procedure is not the ideal treatment for everyone, and there are definite pros and cons concerning lithotripsy for kidney stones. Some benefits of this type of procedure include pain relief, being able to avoid a more invasive surgical procedure, and reducing the chances of developing a urinary blockage or damage to the kidney. Some potential cons of lithotripsy for kidney stones include potential complications such as kidney infections or kidney damage due to the procedure.

Lithotripsy for kidney stones is usually considered for larger stones, as smaller stones will usually pass on their own without any type of medical intervention. Large stones can cause increased pain, and this pain can sometimes be completely incapacitating. Larger stones also have a higher risk of becoming lodged in the tubes, called ureters, that carry urine from the kidneys to the bladder. When this happens, kidney damage is likely to occur. Lithotripsy for kidney stones may be a good option for those with large kidney stones, especially if the stones are causing any kind of urinary blockage.

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Does The Patient Need Anesthesia

Yes, even though there is no incision, there will be pain. You and your doctor will discuss whether light sedation and local or general anesthetics will be used. The choice depends on the technique, the type of stone and the patient. SWL can be delivered with just mild sedation, but in general, some type of anesthesia–either local, regional or general–is used to help the patient remain still, reduce any discomfort, and this improves the breaking of the stone.

Urinary System Parts And Their Functions:

The Urology Group: Lithotripsy for Kidney Stones
  • Two kidneys. A pair of purplish-brown organs located below the ribs toward the middle of the back. Their function is to:
  • Remove liquid waste from the blood in the form of urine
  • Keep a stable balance of salts and other substances in the blood
  • Produce erythropoietin, a hormone that aids the formation of red blood cells
  • Regulate blood pressure

The kidneys remove urea from the blood through tiny filtering units called nephrons. Each nephron consists of a ball formed of small blood capillaries, called a glomerulus, and a small tube called a renal tubule. Urea, together with water and other waste substances, forms the urine as it passes through the nephrons and down the renal tubules of the kidney.

  • Two ureters. Narrow tubes that carry urine from the kidneys to the bladder. Muscles in the ureter walls continually tighten and relax forcing urine downward, away from the kidneys. If urine backs up, or is allowed to stand still, a kidney infection can develop. About every 10 to 15 seconds, small amounts of urine are emptied into the bladder from the ureters.
  • Bladder. A triangle-shaped, hollow organ located in the lower abdomen. It is held in place by ligaments that are attached to other organs and the pelvic bones. The bladder’s walls relax and expand to store urine, and contract and flatten to empty urine through the urethra. The typical healthy adult bladder can store up to two cups of urine for two to five hours.
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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.

    Why Do I Need Extracorporeal Shock Wave Lithotripsy

    Your doctor may offer you extracorporeal shock wave lithotripsy if you have kidney stone that are causing you severe and ongoing pain.

    Kidney stones are often small enough to pass out of your body in your urine without needing any treatment. You may just need to take painkillers while you wait for the stone to pass. Sometimes, your GP may also give you medicine to help the stone pass more quickly. If a kidney stone is causing severe pain that you cant manage at home, your GP may refer you to hospital for further investigation and treatment. They will suggest you go straight to hospital if you have signs of infection, such as a fever.

    If youre referred to hospital because of kidney stones, youll usually have a CT scan or ultrasound, and then be seen by a urologist. This is a doctor specialising in conditions affecting the urinary system. ESWL is one of the treatments to remove your kidney stone that you may be offered.

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    Who May Need Extracorporeal Shock Wave Lithotripsy

    ESWL works differently in various people, and is not always the best choice for someone who has a stone. The following are some of the factors that can affect the procedures success.

    • Stone composition: Stones composed of cystine and certain types of calcium do not break up well with shock waves.
    • Stone location: Stones in very narrow ducts may have trouble passing through or being extracted even after they are broken up.
    • Stone size: Large stones may create big fragments that can be difficult to pass or extract.
    • Preexisting conditions: Certain conditions, such as chronic infection, may make ESWL less effective.

    Some ESWL techniques can make lithotripsy safer and more effective, such as adjusting the power and intervals of the shock waves.

    What Happens During Eswl

    Lithotripsy for Kidney Stones

    The ESWL procedure takes about an hour, and sometimes longer depending on the size and number of the stones. During the procedure:

    • You lie on a table in a specialized treatment room that has the shock wave machine and imaging equipment.
    • After you receive anesthesia, the doctor will use a computerized X-ray machine, sometimes in combination with ultrasound, to pinpoint the stones location.
    • The doctor will place you in the best position to aim the shock waves at the stone.
    • A series of shock waves is released at the stone. The doctor will adjust the power and the intervals of the shock waves as needed to break up the stone.

    Pancreatic duct or bile duct stones broken up by ESWL may need to be extracted with an endoscope, which is done right after the ESWL procedure.

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    What To Expect At Home

    It is normal to have a small amount of blood in your urine for a few days to a few weeks after this procedure.

    You may have pain and nausea when the stone pieces pass. This can happen soon after treatment and may last for 4 to 8 weeks.

    You may have some bruising on your back or side where the stone was treated if sound waves were used. You may also have some pain over the treatment area.

    Extracorporeal Shock Wave Lithotripsy Versus Percutaneous Nephrolithotomy Or Retrograde Intrarenal Surgery For Kidney Stones

    Stones in the urinary tract are a common medical problem. Half of patients with previous urinary stones have a recurrence within 10 years. Kidney stones can cause pain, blood in the urine, infection, decreased kidney function, and kidney failure. The treatment is to remove the stones from kidney. Extracorporeal shock wave lithotripsy disintegrates stones using shock waves and is a minimally invasive technique. Other minimally invasive methods ) and retrograde intrarenal surgery ) are widely used for kidney stones management because ESWL had limited success rate. This review aimed to compare the effectiveness and complications between ESWL and stones removing using the nephroscopy through the skin at kidney level or ureteroscope through the bladder and ureter to the kidney . Five small randomised studies were included. Four studies compared ESWL with PCNL and one study compared ESWL with RIRS. Patients with kidney stones who undergo PCNL have a higher success rate than ESWL whereas RIRS was not significantly different from ESWL. However, ESWL patients spent less time in hospital, duration of treatment was shorter and there were fewer complications.

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    Comparing Ureteroscopy Shockwave Lithotripsy And Percutaneous Nephrolithotripsy

    Understanding what is the best option for treating your kidney stone can be difficult. In our new chart, we summarize the benefits and drawbacks of each surgical option. While it still wont make the decision for you, it can help you to make an informed decision when talking to your urologist. For more detailed information and videos, see our treatment pages

    How The Intervention Might Work

    Dr. Christopher Sherman Discusses Lithotripsy for Kidney Stones – BayCare Health System

    ESWL produces the highenergy shock wave from an external source and focus on the stone within the body. This energy disintegrates the stone into tiny fragments which can spontaneously pass through the urinary system. The shock wave is generated by a machine called a lithotriptor from either electrohydraulic, electromagnetic, or piezoelectric sources .

    Percutaneous nephrolithotomy is an operation to remove stones from the kidney. This surgical procedure must be obtained under anaesthesia. A small skin incision is made and a nephroscope is passed into the kidney to examine the stones. Stones are fragmented by either laser, ultrasonic or electrohydraulic through the nephroscope and then stones are removed. Finally, a nephrotomy tube is placed to drain fluid from the kidney .

    Retrograde intrarenal surgery is a minimally invasive surgical procedure using flexible ureteroscope enters the urethra through the bladder, the ureter, into the kidney. This procedure is a retrograde approach to the intrarenal urinecollecting part and normally done under anaesthesia. The stones can be seen through the scope, then treated with intracorporeal lithotriptors and grasping devices. At present, RIRS is commonly used to remove stones from the kidney. The procedure had to be performed by special expertise in this field .

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    What Else Do You Need To Make Your Decision

    Check the facts

    • That’s right. The smaller a stone is, the more likely it is to pass on its own.
    • No, that’s not right. The smaller a stone is, the more likely it is to pass on its own.
    • It may help to go back and read “Get the Facts.” The smaller a stone is, the more likely it is to pass on its own.
    • No, that’s not right. 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.
    • Yes, that’s right. 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.
    • It may help to go back and read “Get the Facts.” Lithotripsy isn’t the best choice if you are pregnant or have a bleeding disorder, kidney infection, urinary tract infection, kidney cancer, or some other kidney problems.

    How sure do you feel right now about your decision?

    Use the following space to list questions, concerns, and next steps.

    Lithotripsy Treatment For Kidney Stones

    Your doctor has found that you have a stone in your kidney or ureter. The ureter is the tube that connects your kidney to your bladder.

    Kidney stones can be painful and cause infection or blood in your pee . If the kidney stones are not removed, they can grow and damage your kidney or block your ureter.

    You can read more about kidney stones on the NHS website.

    If you have kidney stones, you might have a treatment called lithotripsy. This is a procedure to treat kidney stones.

    The procedure uses shock waves to break your kidney stones into small, sand-like particles. These particles can then pass out of your body through your pee.

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    What Can The Patient Expect After Treatment

    After treatment is complete, the patient can move about almost at once. Many people can fully resume daily activities within one to two days. Special diets are not required, but drinking plenty of water helps the stone fragments pass. Some pain may occur when the fragments pass, which begins soon after treatment and may last for up to four to eight weeks. Oral pain medication and drinking lots of water will help relieve symptoms.

    Eswl For Bile Duct Stones

    Laser Lithotripsy

    Gallstones form in the gallbladder and can travel to the bile ducts, where they may get stuck. Gallstones are usually removed from the bile duct with the help of an endoscope. However, for some larger stones and those that are difficult to reach, ESWL might be used to break them up before extracting.

    In the past, ESWL was used to break up stones in the gallbladder. However, ESWL is not effective in preventing the stones from coming back. Nowadays, minimally invasive gallbladder removal is a more common treatment for gallstones that cause symptoms.

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