Lithotripsy for Kidney Stones (Extracorporeal Shock Wave Lithotripsy)

Physical examX-rayBlood and urine testsIVP (intravenous pyelogram) an x-ray of the urinary system taken after the injection of dye Spiral CT scana type of x-ray that uses a computer to make pictures of structures inside the bodyMRI scan a test that uses magnetic waves to make pictures of structures inside the body Instruct you to stop certain medications before surgery, including aspirin and other blood-thinning agents, to avoid abnormal bleeding Anesthesia In most cases, heavy sedation or general anesthesia is used to help you remain still and avoid discomfort. Description of the Procedure You are placed on a table attached to the lithotripsy equipment. The area being treated will lie on top of a soft cushion or membrane through which the waves pass. Your doctor uses x-rays or ultrasound to locate the stone, then positions your body to target the stone. One to three thousand shock waves are passed through the stones, until they are crushed into pieces as small as grains of sand. After ProcedureYou will be moved to a recovery area where you will be encouraged to drink fluids and may be given fluids through an intravenous (IV) line.

How Long Will It Take?The procedure is typically 45 to 60 minutes. Will It Hurt?Anesthesia prevents pain during the procedure. Pain and discomfort after the procedure can be managed by oral pain medication. There will be some pain and discomfort afterward from the passage of broken stones, and some bruising on the area treated. Possible ComplicationsBlood in the urineBruising in the back or abdomenPain as the stone fragments passNeed for additional treatments Average Hospital StayIf a hospital stay is required, it is up to 2 days long. Postoperative CareYou will be instructed to drink plenty of water in the weeks after the procedure to help the stone fragments pass. You will be able to move almost immediately after the procedure, and you will likely be able to resume daily activities within 1 to 2 days. You may be prescribed oral pain medication to help manage pain and discomfort. OutcomeAbout 70% to 90% of 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 highest success with treatment. If fragments that are too large to pass persist after the procedure, they can be treated with lithotripsy again. Call Your Doctor If Any of the Following Occurs It is essential for you to monitor your recovery once you leave the hospital. That way, you can alert your doctor to any problems immediately. If any of the following occur, call your doctor:

Excessive urge to urinate or inability to urinateExcessive blood in the urinePain between the ribs and groin as stones passSigns of infection such as fever and chillsExtreme pain RESOURCES: National Kidney and Urologic Diseases Information Clearinghousehttp://kidney.niddk.nih.gov National Kidney Foundationhttp://www.kidney.org CANADIAN RESOURCES: Canadian Urological Associationhttp://www.cua.org/ The Kidney Foundation of Canada: Northern Alberta and the Territories Branchhttp://www.kidney.ab.ca References: American Urological Association website. Available at: http://www.afud.org/ . Kidney stones in adults. National Kidney and Urologic Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/stonesadult . Accessed November 11, 2005. Lithotripsy. National Kidney Foundation website. Available at: http://www.kidney.org/atoz/atozPrint.cfm?id=87 . Accessed November 11, 2005. Wash PC, Vaughan ED, Wein AJ, Kavoussi LR, Novick A, Partin AW, et al. Campbells Urology . 8th ed. Saunders; 2002. Last reviewed June 2007 by Miguel Antelo, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.