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Electrohydraulic Lithotripsy

(EHL; Lithotripsy, Electrohydraulic; Intracorporeal Lithotripsy; Lithotripsy, Intracorporeal; Ureteroscopic Stone Removal; Stone Removal, Ureteroscopic)

by Deanna M. Neff, MPH

Definition

Electrohydraulic lithotripsy is one of many methods to treat kidney stones or bile stones. It uses an electrohydraulic device with a flexible probe to deliver electricity that breaks apart the stones.

Kidney Stone

Copyright © Nucleus Medical Media, Inc.

Reasons for Procedure

Lithotripsy is used to remove kidney stones that:

  • Are too large to pass
  • Cause constant pain
  • Block the flow of urine
  • Cause an ongoing infection
  • Damage surrounding tissue
  • Cause bleeding

This procedure can also be used to remove stones in the bile duct or the pancreatic duct.

Gallstones

Gallstones
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Possible Complications    TOP

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Damage or irritation to tissue or surrounding structures
  • Blood in the urine
  • Infection
  • Pain as the stone fragments pass
  • Failure of stone fragments to pass, requiring additional surgery
  • Need for more treatments
  • Reaction to anesthesia

Factors that may increase the risk of complications include:

  • Bleeding disorders or taking medications that reduce blood clotting
  • Smoking

What to Expect    TOP

Prior to Procedure

Before the procedure, your doctor may do the following:

  • Physical exam and medical history
  • Blood and urine tests
  • Imaging studies to find the location of the stone

Other things to remember before the procedure:

  • Arrange for a ride home from the care center.
  • If instructed by your doctor, do not eat or drink for eight hours before the procedure.

Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure. These medications may include:

  • Aspirin or other non-steroidal anti-inflammatory drugs, such as ibuprofen or naproxen
  • Blood thinners, such as warfarin
  • Anti-platelets, such as clopidogrel

Anesthesia

General anesthesia will be used. You will be asleep during the procedure. You will not feel any pain.

Description of the Procedure

Your doctor will place a tiny flexible probe through your urethra and up the ureter toward the stone. The probe has two electrodes at the end. Images will help the doctor locate the stone. After the stone is located, the doctor will use the device. An electrical spark will break the stone. A special basket or forceps may be used to grab the stone fragments and remove them. The stone fragments may be allowed to pass in the urine.

Depending on the size of the stone, more than one probe may be used. A stent may be placed in the ureter. It will help protect the lining while the stone fragments pass or damage is being repaired.

There may be fragments that are too large to pass after the procedure. These can be treated again with lithotripsy.

How Long Will It Take?

30-60 minutes depending on the size and location of the stone

How Much Will It Hurt?

Anesthesia prevents pain during the procedure. There may be some pain and discomfort afterward as the broken stones pass. Ask your doctor about medication to help with the pain.

Average Hospital Stay

This procedure is usually done in an outpatient setting. In most cases, there will be no hospital stay.

Post-procedure Care

At the Care Center

  • You will be monitored as you recover from anesthesia.
  • Pain medication will be given.
  • You may be asked to get up and walk around before leaving the care center.

At Home

Follow your doctor's instructions, which may include:

  • Drinking plenty of water in the weeks after the procedure. This will help the stone pieces to pass.
  • Resuming daily activities within one to two days.
  • You may experience some pain. Take pain medication as directed to manage any discomfort.

Call Your Doctor    TOP

Call your doctor if any of the following occurs:

  • Inability to urinate
  • Excess blood in your urine
  • Signs of infection, including fever and chills
  • Nausea and/or vomiting that you cannot control with the medications you were given
  • Pain that you cannot control with the medications you were given
  • Cough, shortness of breath, or chest pain

If you think you have an emergency, call for medical help right away.

RESOURCES:

American Urological Association Foundation
http://www.urologyhealth.org
National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov

CANADIAN RESOURCES:

Canadian Urological Association
http://www.cua.org
Kidney Foundation of Canada
http://www.kidney.ca

References:

Cystoscopy and ureteroscopy. National Kidney and Urologic Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/cystoscopy/. Updated March 28, 2012. Accessed May 22, 2013.
Gallstones. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what. Updated April 10, 2013. Accessed May 22, 2013.
Kidney stones in adults. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/stonesadults/. Updated January 28, 2013. Accessed May 22, 2013.
Nephrolithiasis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what. Updated May 17, 2013. Accessed May 22, 2013.
Ureteroscopy. National Kidney Foundation website. Available at: http://www.kidney.org/atoz/content/kidneystones_Ureteroscopy.cfm. Accessed May 22, 2013.
Last reviewed May 2013 by Adrienne Carmack, MD; Brian Randall, MD
Last Updated: 5/22/2013