Lithotripsy

Answer 1

Definition

Lithotripsy is a medical procedure that uses shock waves to break up stones in the kidney, bladder, or ureter (tube that carries urine from your kidneys to your bladder). After the procedure, the tiny pieces of stones pass out of your body in your urine.

Alternative Names

Extracorporeal shock wave lithotripsy; Shock wave lithotripsy; Laser lithotripsy; Percutaneous lithotripsy; Endoscopic lithotripsy; ESWL

Description

Extracorporeal shock wave lithotripsy (ESWL) is the most common type of lithotripsy. "Extracorporeal" means outside the body.

You will wear a medical gown and lie on an exam table on top of a soft, water-filled cushion. You will be given a mild sedative or pain medicine before the procedure starts. You will also be given antibiotics before the procedure starts to prevent infection.

High-energy shock waves, also called sound waves, will pass through your body until they hit the kidney stones. You may feel a tapping sensation when this starts. The waves break the stones into tiny pieces. Often, you will be given general anesthesia for the procedure. You will be asleep and pain-free.

The lithotripsy procedure should take about 45 minutes to 1 hour.

A tube may be placed through your bladder or back into your kidney. This tube will drain urine from your kidney until all the small pieces of stone pass out of your body. The tube may be put in place before or after your lithotripsy treatment.

See also: Percutaneous urinary procedures

Why the Procedure Is Performed

Lithotripsy is used to remove kidney stones that are causing:

• Bleeding
• Damage to your kidney
• Pain
• Urinary tract infections

Risks

Lithotripsy is usually safe. Ask your doctor about these possible complications.

• Bleeding around your kidney, which may need a blood transfusion
• Kidney infection
• Pieces of the stone block urine flow from your kidney (this may cause severe pain or damage to your kidney)
• Pieces of stone are left in your body (you may need more treatments)
• Ulcers in your stomach or small intestine
• Your kidneys may not work as well, or they may stop working, after the procedure

Before the Procedure

Always tell your doctor or nurse:

• If you are or could be pregnant
• What drugs you are taking, even drugs, supplements, or herbs you bought without a prescription

During the days before the surgery:

• You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), and any other drugs that make it hard for your blood to clot. Ask your doctor when to stop taking them.
• Ask your doctor which drugs you should still take on the day of the surgery.

On the day of your procedure:

• You will usually be asked not to drink or eat anything for several hours before the procedure.
• Take the drugs your doctor told you to take with a small sip of water.
• Your doctor or nurse will tell you when to arrive at the hospital.

After the Procedure

After the procedure, you will stay in the recovery room for up to about 2 hours. Most people are able to go home the day of their procedure.

See also: Lithotripsy - discharge

Outlook (Prognosis)

How well you do depends on the number of stones you have, their size, and where in your urinary system they are. Usually, lithotripsy completely removes the stones.

References

Curhan GC. Nephrolithiasis. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 128.

Lingeman JE, Matlaga BR, Evan AP. Surgical management of upper urinary tract calculi. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, PA: Saunders; 2007:chap 44.

Reviewed By

Review Date: 09/16/2011

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.