Lithotripsy is a 30 - 90-minute non-invasive kidney stone treatment procedure which breaks the stones in the body into small fragments. Lithotripsy can be performed to break stones in the various organs of the body such as kidney, gallbladder, liver, etc.
There are several types of lithotripsy procedures for kidney stones removal:
- Extracorporeal shock wave lithotripsy (ESWL)
- Shockwave lithotripsy (SWL)
- Laser lithotripsy
- Percutaneous lithotripsy
- Endoscopic lithotripsy
A local, regional, or general anesthesia is used, depending on the patient’s assessment and the technique to be used. Anesthesia helps the patient to remain still and reduce any discomfort. Lithotripsy can also be delivered with light sedation.
How is the lithotripsy procedure performed?
Extracorporeal shock wave lithotripsy (ESWL): Shock waves are used to break the kidney stones into smaller pieces that can now easily pass through the urinary tract. This procedure is generally used to remove stones which are 4 mm to 20 mm in diameter.
Shockwave lithotripsy (SWL): High-energy shock waves are targeted directly at the kidney stones, causing each stone to fragment and become small enough to pass through the urinary tract. The results of SWL are generally satisfactory if the size of the stone is less than 20 mm in diameter.
Laser lithotripsy: In this procedure, a laser is directly targeted onto the kidney stones to break them into smaller pieces, which then pass through the urinary tract. Laser lithotripsy works best with stones less than 20 mm in diameter.
Percutaneous lithotripsy: This is a minimally invasive procedure, in which a tiny incision of approximately 1 cm is made through the skin. A hollow tube with a probe is inserted through the incision into the kidney. The stone is then broken into fragments and removed through the tube. This procedure is generally used to remove stones larger than 20 mm in diameter.
Endoscopic lithotripsy: In this procedure, an endoscope or cystoscope is used to reach the stone, through the urinary tract. Laser waves are then directed onto the stone to break it into small fragments.
Am I eligible for lithotripsy?
You are eligible for lithotripsy if:
you have small kidney stones (generally smaller than 2 cm) easily seen on an X-Ray
you have stones in the upper portion of the ureter
You are ineligible for lithotripsy if you:
have active urinary tract infection
display symptoms of obstruction of the kidney
take blood-thinning medications that cannot be discontinued
have a stone composition which includes cystine and certain types of calcium phosphate stones, as these stone types may not fragment well during the lithotripsy procedure.
What are the complications of lithotripsy?
Complications of lithotripsy may include, but are not limited to, the following:
bleeding around the kidney
stone fragments left behind making it necessary to undergo more lithotripsy procedures
obstruction of the urinary tract by stone fragments
blood in urine
What are the post-operative guidelines I need to follow after undergoing a lithotripsy procedure?
Following are the post-operative guidelines after getting a lithotripsy done:
You may observe blood in the urine after the lithotripsy procedure. This is a temporary condition which clears up after a few days.
The doctor may instruct you to collect your urine for about 24 hours after the procedure and send it to the laboratory for analysis of the stone debris.
You will be advised to drink extra fluids to maintain good kidney health. It will help to dilute your urine and reduce any discomfort when the stone fragments pass.
Drinking plenty of water will also reduce the chances of recurrence of kidney stones. So, make water your most frequent drink.
Promptly take all the medications prescribed by the doctor.
Regularly follow up with your urologist as recommended to ensure an uneventful recovery.
If a stent is inserted during lithotripsy, it is normally removed when you begin to recuperate. After 7 to 10 days of undergoing the procedure, you can resume your normal activities.
You will be advised by the doctor to refrain from smoking and drinking alcohol for several weeks. Smoking and drinking alcohol can impede the healing process.