What is a lithotripsy for kidney stones?

A lithotripsy for kidney stones is a nonsurgical procedure in which the doctor uses sound waves from a lithotripsy machine to break up stones in your kidney. The stone pieces are then flushed out in the urine.

When is it used?

This procedure may be done when the kidney stones are painful, are causing kidney damage, or are blocking the flow of urine to the bladder. The stones may destroy kidney function if they are not treated. The stones can also cause infection. Sometimes they cause heavy bleeding and shock (the slowing down or stopping of life-sustaining bodily processes).

Not all kidney stones can be treated with lithotripsy. Ask your doctor about the characteristics of your stones (for example, their size and shape) and whether lithotripsy is an option for you.

An alternative to this procedure is to have the kidney stones removed surgically. Sometimes the stones can be dissolved with medication. You could choose not to have treatment, recognizing the risks of your problem. You should ask your doctor about these choices.

You should not have lithotripsy if you are pregnant, have a pacemaker, or have serious problems with your heartbeat.

How do I prepare for lithotripsy?

Plan for your care and recovery after the operation. Allow for time to rest and try to find people to help you with your day-to-day duties.

For 1 week before your surgery, do not take aspirin, ibuprofen (such as Motrin or Advil), or any other nonprescription pain relievers except for acetaminophen (such as Tylenol). You may take acetaminophen for pain.

Follow any instructions your doctor may give you. Eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.

What happens during the procedure?

You will be given a local or general anesthetic. A local anesthetic numbs part of your body while you remain awake. The general anesthetic will relax your muscles and put you in a deep sleep. Both types of anesthetic will prevent you from feeling pain during the operation.

The doctor may put tubes into your ureter (the tube connecting the kidney to the bladder). You lie on a table over the lithotripsy machine. The lithotripsy machine sends sound waves against the kidney stones, breaking them. The doctor uses x-rays to find the kidney stones, keep the sound waves focused on them, and track their breakdown. The stones can then pass down your ureters into the bladder after a few days.

What happens after the procedure?

You may be in the recovery room for a few hours to recover from the anesthetic before going home. Any pain you may have felt with the kidney stones before this treatment may continue as the pieces of stone pass out of the ureter into the bladder. Drink a lot of fluids to help keep stones from reforming and to flush out the remaining pieces of stone. You may be given medication to prevent stones from reforming.

If you had tubes placed in your ureter the doctor may take them out in 3 to 10 days. During that time you may need to go to the bathroom more often than usual.

Ask your doctor how you should care for yourself at home and when you should come back for a checkup.

What are the benefits of this procedure?

You may be rid of the kidney stones and the problems they might cause without surgery.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your doctor.

• A local anesthesia may not numb the area quite enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia. Local anesthesia is considered safer than general anesthesia.

• There is a risk of infection or bleeding.

• Some of the broken kidney stones could irritate the bladder or ureter or block the ureter.

• There is a small risk you may need another procedure if a blockage occurs or if leftover pieces of stone remain in the kidneys or ureters.

• On rare occasions there could be serious complications such as shock.

You should ask your doctor how these risks apply to you.

When should I call the doctor?

Call the doctor immediately if:

• You develop a fever.

• You have increasing pain.

• You cannot urinate.

• If urine remains bloody beyond the first night.

Call the doctor during office hours if:

• You have questions about the procedure or its result.

• You want to make another appointment.