Lithotripsy - The Kidney Stone Solution

Lithotripsy is a procedure used to treat kidney stones that are too large to pass through the urinary tract. It works by sending focused ultrasound energy or shock waves directly to the stone. The shock waves breakup a large kidney stone so that it will pass through the urinary system. Lithotripsy lets people with certain types of kidney stones avoid surgery.

When substances normally excreted through the kidneys stay in the kidney, they may crystallize and harden into a kidney stone. If the stones break free, they can get stuck in, the narrower passages of the urinary tract. Some kidney stones are small or smooth enough to pass easily through the urinary tract without discomfort. Other stones may have rough edges or grow as large as a pea. These can cause great pain as they move through or stick in the urinary tract. The areas that are more prone to trapping kidney stones are the bladder, ureters, and urethra.

“Since lithotripsy services were introduced at CVMC in 1989, we’ve grown to treat about 300 patients a year at CVMC,” says Bruce Billington, Coordinator of Lithotripsy.

What happens during lithotripsy? Lithotripsy services at CVMC are provided on an outpatient basis. Generally, lithotripsy follows this process:

1. After the stone(s) has been found with fluoroscopy, you will be positioned for the best access to the stone.
2. Patient is anesthetized during the procedure and feels no pain
3. A series of shock waves will be sent to shatter the kidney stone(s).
4. The stone(s) will be monitored by fluoroscopy during the procedure.
5. Once the stone fragments are small enough to pass through the urinary system, the procedure will end.

After lithotripsy you will be taken to the recovery area for observation. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be discharged home. Plan to have someone give you a ride home. You should not drive for at least 24 hours after getting sedatives for the procedure. Your healthcare provider will provide specific post procedure instructions that often include:

• When to resume your usual diet and activities
• You will be encouraged to drink extra fluids to dilute the urine and reduce the discomfort of passing stone pieces
• You may notice blood in your urine for a few days or longer after the procedure. This is normal
• You may notice bruising on the back or belly. This is also normal
• Take a pain reliever for soreness as recommended by your healthcare provider. Avoid aspirin or certain other pain medicines. They may increase the chance of bleeding. Be sure to take only recommended medicines
• You may be given antibiotics after the procedure. Be sure to take the medicine exactly as prescribed
• You may be asked to strain your urine so that remaining stones or stone pieces can be sent to the lab for testing
• A follow-up appointment will be scheduled within a few weeks after the procedure. If a stent was placed, it may be removed at this time

How you can minimize recurring kidney stones:
People who have had one kidney stone are prone to develop others. Without preventive treatment or changes in lifestyle, patients can develop a new stone. About 80% of patients develop additional stones and half of these do so within 5 to 10 years of the first stone. If you have had kidney stones before, you are more likely to have kidney stones again. To help keep future stones from forming, try to:

• Drink 6 to 8 glasses of water each day
• Eat less salt (sodium), meat and eggs
• Talk to your doctor about medications and other tests for kidney stones

What should you do if you think you have a kidney stone?

If you are having symptoms of a kidney stone, see your healthcare provider at your earliest convenience.