Extracorporeal Shock Wave Lithotripsy for Kidney Stones

(Lithotripsy for Kidney Stones)

Definition

Extracorporeal shock wave lithotripsy is a nonsurgical treatment for kidney stones. It uses high-energy shock waves to break the stones into tiny pieces. The pieces can then be passed with urine.

Kidney Stones

Kidney Stones
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Reasons for Procedure    TOP

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 kidney tissue
  • Cause bleeding

Most people who have lithotripsy for kidney stones are free of stones within three months of treatment. Patients with stones in the kidney and upper ureter have the most success with treatment. There may be fragments that are too large to pass after the procedure. They can be treated with lithotripsy again.

Possible Complications    TOP

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

  • Blood in the urine
  • Bruising in the back or abdomen
  • Pain as the stone fragments pass
  • Failure of stone fragments to pass, requiring additional surgery
  • Need for additional treatments
  • Reaction to anesthesia

Some factors that may increase the risk of complications include:

  • Bleeding disorders or taking medications that reduce blood clotting
  • Obesity
  • Skeletal deformities

What to Expect    TOP

Prior to Procedure

Your doctor may do the following:

  • Physical exam
  • Blood and urine tests
  • Imaging studies to help locate the stones

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

  • Anti-inflammatory medications, such as ibuprofen and naproxen
  • Blood thinners
  • Anti-platelet medications

Anesthesia

Heavy sedation or general anesthesia is usually used. Heavy sedation will keep you calm. With general anesthesia, you will be asleep. It will help you remain still and avoid discomfort.

Description of the Procedure    TOP

You will be placed on a soft cushion on top of a table. Shock waves can be passed to the stones through this cushion.

X-rays or ultrasound will be used to locate the stone. Your body will be positioned to target the stone. Shock waves will be passed through the stones until they are crushed. They will be crushed into pieces as small as grains of sand.

How Long Will It Take?    TOP

45-60 minutes

How Much Will It Hurt?    TOP

Anesthesia prevents pain during the procedure. There may be some pain and discomfort afterward from the passage of broken stones. There may also be some bruising on the area treated. Pain and discomfort after the procedure can be managed with medication.

Postoperative Care    TOP

You will be able to move almost immediately after the procedure. Drink plenty of water in the weeks after the procedure to help the stone pieces pass.

Call Your Doctor    TOP

After arriving home, contact your doctor if any of the following occurs:

  • Extreme urge or inability to urinate
  • Excessive 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 after the procedure
  • Pain that you cannot control with the medications you have been given
  • Cough, shortness of breath, or chest pain

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

RESOURCES:

National Kidney Foundation
http://www.kidney.org
National Kidney and Urologic Diseases Information Clearinghouse
http://kidney.niddk.nih.gov

CANADIAN RESOURCES:

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

References:

Kidney and ureteral stones: Surgical management . American Urological Association website. Available at:
...(Click grey area to select URL)
Updated January 2011. Accessed March 3, 2014.
Kidney stones in adults. National Kidney and Urologic Diseases Information Clearinghouse website. Available at:
...(Click grey area to select URL)
Updated January 28, 2013. Accessed March 3, 2014.
Lithotripsy. National Kidney Foundation website. Available at:
...(Click grey area to select URL)
Accessed March 3, 2014.
Nephrolithiasis. EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
Updated January 17, 2014. Accessed March 3, 2014.
Last reviewed March 2014 by Adrienne Carmack, MD
Last Updated: 3/3/2014