Can Lithotripsy Safely Break Up Your Kidney Stones?
As a urologist practising in Birmingham, I’m always pleased to offer a patient with a painful kidney stone an effective treatment like lithotripsy that doesn’t require invasive surgery. Many are pretty relieved they have an option to break up stones noninvasively.
In this article, I want to provide an overview of extracorporeal shock wave lithotripsy based on my experience using it to treat hundreds of patients over my career. I’ll explain the lithotripsy procedure, who makes a good candidate, and what to expect during treatment and afterwards.
My goal is to help you understand the value of this noninvasive option to eliminate kidney stones without the risks of surgery.
An Introduction to Extracorporeal Shock Wave Lithotripsy
Extracorporeal shock wave lithotripsy (ESWL) is a procedure that uses targeted ultrasonic shock wave pulses focused on the stone through the skin to fragment it into tiny pieces. This allows the stone particles to pass out of the body in urine without surgery to remove them.
The whole process is done outside the body (extracorporeal) and usually takes 30-60 minutes. It is typically performed as an outpatient procedure with little to no recovery time needed afterwards.
Overall, it’s a convenient and noninvasive way to break up stones.
Determining Who Is a Good Candidate for Lithotripsy
Lithotripsy tends to work best for:
- Stones located in the kidney or upper ureter that are 1-2 cm large. Larger or lower stones may need alternate treatment.
- Single large stones or a handful of smaller stones. Multiple stones can usually all be targeted.
- Patients healthy enough to tolerate brief anaesthesia required for the procedure.
- Those wishing to avoid invasive surgical stone removal procedures.
Many of my Birmingham patients meet these criteria and express interest in trying lithotripsy before considering surgery.
What to Expect During the Lithotripsy Procedure
The lithotripsy procedure involves:
- Being placed on a water-filled table with the shock wave device positioned over your stone’s location.
- Imaging like ultrasound or X-ray to precisely target the shock waves to the stone.
- Up to 3000 shocks were delivered over 30-60 minutes to fragment the stone into dust.
- Feeling a tapping sensation with each shock – anaesthesia prevents actual pain.
- Potentially receiving medication after to relax ureters to help pass fragments.
- Spending 1-2 hours recovering before being discharged home the same day.
Overall, it is quick and comfortable due to the anaesthesia.
Passing the Stone Fragments After Successful Lithotripsy
After lithotripsy, I advise patients to:
- Drink plenty of fluids to flush out the stone pieces and urinate frequently.
- Strain urine to collect passed fragments so we can assess results.
- Understand it may take days or weeks for the full effects of treatment to be realised as fragments slowly work their way out.
- Potentially need additional lithotripsy if imaging shows residual fragments.
- Get follow-up imaging to confirm eventual complete clearance.
With patience and diligence, lithotripsy can successfully and noninvasively eliminate kidney stones.
