Why get lithotripsy?
Extracorporeal shock wave lithotripsy is a procedure used to treat some kidney stones. During the procedure, a lithotripter machine uses shock waves to break a kidney stone into smaller passable pieces. Typically, people will have lithotripsy performed when the stone is in the upper third of the urinary tract and a size that can be seen by fluoroscopy, similar to an X-ray “movie.” If your doctor can see the stone through fluoroscopy, then it can generally be treated through lithotripsy.
Not all kidney stones can be treated effectively using lithotripsy. You will need to talk with your doctor about what is appropriate for your case.
What happens during the procedure?
The shock waves generate enough power and force that it hurts. Because of this, you'll generally be placed under some form of anesthesia and fall asleep.
This is also to ensure that you don't move. It's important that you don't move because the shock waves are focused on your kidney stone. Medical professionals will use X-ray to refine the focal point of where they're targeting the shock waves.
It's up to the patient to pass the stone once it's broken. If your anatomy is correct and you drink enough water, hopefully the passage occurs without any problem. Some patients find that, after lithotripsy, it doesn't hurt as much to pass the stone.
Lithotripsy machines can send up to 2,500 shock waves to the kidney. It's not generally recommended to go higher, for risk of damaging the kidney. If the stone is in the kidney, the procedure works in the majority of patients. In this scenario, you'll discharge the fragments in about a month. If the stone is the ureter, the tube leading from the kidney to the bladder, it will be discharged about 80 percent of the time.
Does it hurt?
You're generally asleep during the procedure and shouldn't feel anything. After the procedure, you might have some bruising on your skin and around the kidney.
What are the risk factors?
There's a risk that you'll suffer bleeding around your kidney or around other organs near the kidney. There's also risk related to the anesthesia. Sometimes, there's infection around the stone, and once it's broken, a patient suffers a urinary tract infection or an infection in the blood stream. These risks are all fairly rare. It's one of the least risky of the procedures used to treat kidney stones.
What's the recovery time?
Lithotripsy is an outpatient procedure, meaning you generally go home that day. It will take about an hour. As long as everything goes well after the procedure, you should be able to return to work and an exercise routine after about five days.
What's the follow-up?
Your doctor will likely want to see you after about a week to ensure you're doing OK. Your doctor will also probably schedule appointments over the three months after your lithotripsy procedure to ensure that you're recovering without complications.
Some patients' stones won't break during lithotripsy; some stone substances are too hard to be broken by the shock waves. At this point, other surgical options may be considered.
Dr. James Wendelken, urologist and president of the Oklahoma Lithotripter Associates board; Johns Hopkins Medicine; The Mayo Clinic.