Electrohydraulic Lithotripsy
(EHL; Intracorporeal Lithotripsy; Ureteroscopic Stone Removal
Definition
Electrohydraulic lithotripsy is one of many methods to treat kidney stones. It uses an electrohydraulic device with a flexible probe to deliver electricity that breaks apart the 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 surrounding tissue
- Cause bleeding
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
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
- Smoking
- Drinking
- Chronic disease such as diabetes or obesity
Your risk of complications may increase if you have bleeding disorders or are taking medications that reduce blood clotting.
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 8 hours before the procedure.
Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure.
Anesthesia
General anesthesia will be used. You will be asleep during the procedure.
Description of the Procedure TOP
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 locate the stone. After the stone is located, the device will be used. 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? TOP
30-60 minutes depending on the size and location of the stone
How Much Will It Hurt? TOP
Anesthesia prevents pain during the procedure. Pain and discomfort after the procedure can be managed with medications.
Average Hospital Stay TOP
This procedure is usually done in an outpatient setting. In most cases, there will be no hospital stay.
Post-procedure Care TOP
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.
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
- Washing their hands
- Wearing gloves or masks
There are also steps you can take to reduce your chances of infection such as:
- Washing your hands often and reminding visitors and healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
At Home
Be sure to drink plenty of water in the weeks after the procedure. This will help the stone pieces to pass.
Call Your Doctor TOP
Call your doctor if any of these occur:
- Inability to urinate
- Excess blood in your urine
- Signs of infection, including fever and chills
- Persistent nausea or vomiting
- 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 emergency medical services right away.
RESOURCES:
National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov
Urology Care Foundation
http://urologyhealth.org
CANADIAN RESOURCES:
Canadian Urological Association
http://www.cua.org
Kidney Foundation of Canada
https://www.kidney.ca
REFERENCES:
Cystoscopy & ureteroscopy. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/diagnostic-tests/cystoscopy-ureteroscopy. Accessed January 29, 2021.
Kidney stones. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/urologic-diseases/kidney-stones. Accessed January 29, 2021.
Nephrolithiasis. EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
Accessed January 29, 2021.
Ureteroscopy. National Kidney Foundation website. Available at: https://www.kidney.org/atoz/content/kidneystones_ureteroscopy. Accessed January 29, 2021.
Last reviewed March 2020 by
EBSCO Medical Review Board
Adrienne Carmack, MD
Last Updated: 1/29/2021