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Lithotripsy:  aka Kidney Stone Treatment




What Is It?


Lithotropsy is a procedure that helps relieve kidney stones by breaking them up or shattering them into smaller pieces so they can be excreted or passed through the body. Kidney stones in the kidneys, bladder, ureters or gallbladder can all be treated with lithotripsy.


Other names for this procedure and similar procedures include “nephrolithiasis” “intravenous pyelogram” or IVP and the “lithotripsy procedure”. Some healthcare providers also call it a “shock wave” lithotripsy because of the shocks introduced into the stone to shrink or destroy it. Laser lithotripsy and endoscopic lithotripsy all do the same thing.




The Operation


The most common type of lithotripsy is known as extracorporeal shock wave lithotripsy or ESWL. The patient lies on an examination table on a cushion filled with water, and often given a sedative or pain reliever to ease any discomfort that occurs during the procedure. Then the doctor will use radiography in the form of ultrasound or an x-ray to locate kidney stones in the body. Once they are visualized the doctor sends shock waves or sound waves of high energy to the kidney stones. These waves pass through the body.


Some people feel a tingling or tapping sensation during the procedure, but generally no pain is experienced. These intense high-energy waves break up stones into very small pieces that can be easily excreted through the bladder. Most of the time the procedure is done within one hour.




Alternatives to Surgery


A lithotripsy IS an alternative to surgery because the doctor will not have to make incisions or cut into the body to remove kidney stones. This is an external procedure where the doctor applies high-energy shock waves to the exterior of the body. These energy waves penetrate the body, locate kidney stones and cause them to break apart. These energy waves do not harm the organs or cause damage to other body parts.




Before The Operation


Before the procedure most patients will have to fast for eight to twelve hours. Your doctor will provide you with specific instructions about fasting or cleansing required before your test. You will review your medications with your doctor. Some patients will have to stop taking certain medications including medications that can thin the blood like aspirin, ibuprofen, coumadin and related medications.




After The Operation


Immediately following surgery most patients can leave as this is generally an outpatient procedure with little pain. Most patients will pass the remaining kidney stone particles during urination. This process is a lot less painful than passing large kidney stones through the bladder.




Possible Complications


There are instances where lithotripsy does not work. In cases like this a patient may need to pursue other options like using a laser to destroy kidney stones. When a laser is used a doctor typically has to introduce an endoscope into the body through the urinary tract. Most patients will have to undergo general anesthesia for this to happen, although this is still a minimally invasive technique. Laser lithotripsy is also performed on an outpatient basis, although it has more risks than a traditional lithotripsy procedure.


Sometimes the kidney stones cannot be broken up and a doctor will have to perform a surgery to remove the kidney stones. In cases like this many potential side effects may occur including infection. A urinary tract infection is possible especially if the laser lithotripsy procedure must be performed. Some additional potential complications may include:


  • Sometimes pieces of a kidney stone get left in the body.
  • In certain cases bleeding can occur around the kidney resulting in a need for a blood transfusion.
  • Rarely damage to kidney tissue may occur although this is not common.
  • Occasionally the flow of urine can be blocked because pieces of stone are too large to pass through the ureters. This can cause additional pain or an infection. This may also necessitate another procedure to correct the problem.




General Advice


A lithotripsy is a relatively safe procedure that helps remove large kidney stones by shattering them into smaller pieces so they can pass through the ureters during urination. This procedure usually involves the use of shock waves to break up large kidney stones so they are more easily passed through the body.


This procedure doesn’t always work however, and some patients must undergo another procedure, a laser lithotripsy, that requires insertion of an endoscope into the ureters to pass laser shock waves to the kidney stone. Once the kidney stone is broken into pieces, there is still a small chance the pieces can get stuck and result in a blockage or infection. For the most part however, many patients recover well and are able to get on with their lives following this procedure.


Your doctor can help you assess whether you are a good candidate for a lithotripsy. Most patients will only have to stay at most 2 to 3 hours in the recovery room following this procedure, unless they have to undergo a more invasive percutaneous lithotripsy, which requires an overnight stay in the hospital. All patients should have someone available to drive them to and from the hospital. Drinking plenty of water will help patients pass kidney stone pieces more easily following the procedure. Sometimes the doctor will ask patients to collect kidney stones they pass for examination following the procedure.





Estimated Costs for Lithotripsy


The cost of lithotripsy varies depending on the number of kidney stones you have, how large they are and what type of lithotripsy you need. Some patients may require additional procedures following the initial course of therapy.


Country Costs
USA $3,000-$8,000
Malaysia $1,500-$3,000
Singapore $1,500-$3,800
India $1,000-$1,500

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