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Treating Kidney Stones: Lithotripsy Procedure



There are a number of procedures now available to treat kidney stones. Depending on the type, size and severity of the stones you have will determine just what kind of treatment works best for you. This page discusses how extracorporeal shock wave lithotripsy (ESWL) works, where it has the highest success rate, and warnings about certain complications associated with this procedure.

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How Lithotripsy Works

There are several types of lithotripsy procedures. All of these options are often done on an outpatient basis with only some requiring the use of anesthesia. Besides its success rate as a relatively simple procedure, the other benefit of lithotripsy is that the recovery time is only a few days.

Here’s how it works. The person receiving the treatment either lies down in a water bath or on a cushion. The doctor employs an x-ray or ultrasound machine to locate the stone. The ultrasound machine sends out numerous high-energy shockwaves which pinpoint and shatter the kidney stones into a fine powder that can be passed out of the body through the urine with no pain or discomfort.

Complications with the Lithotripsy Procedure

Like any kind of medical treatment, lithotripsy does have its complications. It is important to consider all of these before making a decision on whether the lithotripsy procedure is right for you.

The most frequent complication is blood in the urine. This can occur for a few days after the treatment during the recovery period. However, you can reduce the chances of this happening by avoiding aspirin and other NSAIDs for up to 7-10 days after the treatment.

Sometimes, the kidney stone fragments that are left after lithotripsy make contact with the urinary tract walls, causing a cramping pain as they are passed out of the body. This complication will subside as soon as the kidney stone has been completely eliminated. However, if the stones are not completely removed after lithotripsy, new stones could develop more quickly than someone who had not been treated with this procedure.

If it takes more time to eliminate kidney stones, doctors may insert a small tube into the ureter. While this does not speed up the process, it does help ease passage of stone fragments. In other cases, more lithotripsy treatments may be needed to completely shatter the stone into small enough pieces to eliminate all the debris. Other people who have cysts or kidney abnormalities may experience additional complications that further lower the success rate of lithotripsy.

Lithotripsy and Young Patients

There is still uncertainty about the safety or long-term complications involved with using the lithotripsy procedure on children. While it appears to be a safe treatment for younger patients, some researchers discovered short-term injury to the kidney tubules after lithotripsy. The number of ultrasound shocks should be minimized when conducting lithotripsy on children with longer periods of time between treatments if more than one session is required to destroy the kidney stone.

When Lithotripsy Works Best

The lithotripsy procedure has the highest kidney stone recovery rate - approximately a 90% cure - on kidney stones less than half of an inch that do not pass on their own and that are located in the upper portion of the ureter or the pelvic area of the kidney. This scenario for success most closely describes struvite stones.

Based on the size and type of kidney stone, lithotripsy prevents 65%-75% of people from ever having to deal with this painful ailment again. For example, uric acid kidney stones and some calcium stones can be treated successfully. There are certain types of calcium stones that do not break up easily and leave fragments behind that can lead to additional stones in the future. In these cases, complete recovery after the lithotripsy procedure is only about 40%. While smaller cystine stones are easy to treat, the large ones present a challenge. Staghorn kidney stones only result in a success rate of less than 50% with 60% of these cases needing re-treatment.

People who have only had one stone also have a better chance of success using this treatment. Other situations that seem to be aided by lithotripsy are people who have misshapen kidneys. Those who have health conditions that put them at risk for surgery, including diabetes, breathing problems, hypertension and heart disease, have a better chance using lithotripsy because it does not involve major surgery.

 Unfortunately, the lithotripsy procedure does not help everyone. There are also occurrences when this procedure has never been successful. Lithotripsy has been proven not to work for any type of kidney stone that is larger than one inch in diameter. Also, if any part of the stone remains in the urinary tract after the lithotripsy procedure, the possibility remains that new stones could develop.

Resuming Sexual Activity

After having lithotripsy, sexual activity can resume once certain specifications are met. Eating and fluid intake must return to normal. Pain medication is no longer necessary. Lastly, no visible blood appears in the urine. These factors must be fulfilled to ensure that the person does not experience pain or leave themselves open for a possible infection.


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