Kidney Stone Treatment: Lithotripsy

When kidney stones are too large to pass through the urinary system naturally, it becomes necessary to remove them through surgery or other alternative medical procedures. One of the most common of these procedures is lithotripsy, which breaks up the kidney stones into tiny fragments with the use of shock or sound waves.

There are different types of lithotripsy. The widely-used typed is "extracorporeal shock wave lithotripsy" or ESWL. The word "extracorporeal" means "outside of the body" so for this type lithotripsy, the doctor will not cut into the person to get to the kidney stones.

How is this lithotripsy procedure performed?

Several hours before the procedure, the doctor will ask the patient not to eat or drink anything. The doctor will also prescribe a mild painkiller or sedative to relieve mild discomfort during the lithotripsy. To begin the actual procedure, the patient wears a medical gown then lies down on an examination table atop a water-filled bed.

The doctor will locate the kidney stones using an x-ray or ultrasound imaging device. The doctor will then use another device to administer shock waves through the patient's body to the location of the kidney stones. The high wave energy will shatter the stones into very small pieces so the body can get rid of them when the person urinates. This lithotripsy procedure typically takes 45 minutes to an hour.

ESWL is a great alternative treatment to surgery because it allows the removal of kidney stones without the need for incisions, making the procedure less painful with faster recovery. ESWL is an outpatient procedure so there is also need to stay overnight in the hospital.

However, before undergoing lithotripsy, it is very important that patients tell their doctors about any medications they are taking. You should not take ibuprofen, aspirin or blood-thinning drugs a number of days before the schedule procedure. Pregnant women cannot undergo lithotripsy.

ESWL is the usual treatment option for majority of patients with large kidney stones. However, there are some types of kidney stones where ESWL is not the appropriate procedure to use. In this case, the doctor may perform laser lithotripsy instead. In this procedure, the doctor inserts a tube called an endoscope through the urinary tract in order to reach the stone. The patient will be under general anesthesia during laser lithotripsy but will be able to leave the hospital on the same day.

Laser lithotripsy also becomes an option if an earlier ESWL procedure failed to remove the stones or for any reason that the patient is not a suitable candidate for ESWL. The risks of complications with laser lithotripsy are greater than with ESWL.

An even more complicated lithotripsy procedure is percutaneous lithotripsy, wherein the doctor will have to access the stones from the back of the patient. This procedure is performed only when the kidney stones are very large.