Extracorporeal Shock Wave Lithotripsy for Kidney Stones
En Español (Spanish Version)

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

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Reasons for Procedure
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
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
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
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?
45-60 minutes

How Much Will It Hurt?
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
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
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

National Kidney and Urologic Diseases Information Clearinghouse

CANADIAN RESOURCES:
Canadian Urological Association

The Kidney Foundation of Canada

References:
Kidney and ureteral stones: Surgical management . American Urological Association website. Available at: http://www.urologyhealth.org/urology/index.cfm?article=32. Updated January 2011. Accessed March 3, 2014.

Kidney stones in adults. National Kidney and Urologic Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/KUDiseases/pubs/stonesadults/index.aspx. Updated January 28, 2013. Accessed March 3, 2014.

Lithotripsy. National Kidney Foundation website. Available at: http://www.kidney.org/atoz/content/lithotripsy.cfm. Accessed March 3, 2014.

Nephrolithiasis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 17, 2014. Accessed March 3, 2014.

Last Reviewed March 2014



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