Lithotripsy is a noninvasive (the skin is not pierced) procedure used to treat kidney stones that are too large to pass through the urinary tract. Lithotripsy treats kidney stones by sending focused ultrasonic energy or shock waves directly to the stone first located with fluoroscopy (a type of x-ray “movie”) or ultrasound (high frequency sound waves). The shock waves break a large stone into smaller stones that will pass through the urinary system. Lithotripsy allows persons with certain types of stones in the urinary system to avoid an invasive surgical procedure for stone removal. It should be noted that lithotripsy is not suitable for all types of kidney stones.
There are two types of shock wave technology. The original lithotripsy machines sent the shock waves through water in a tub in which the person being treated was placed. This technology remains in use today. More recently, machines have been developed that send shock waves through padded cushions on a table, so the procedure does not involve immersing a person in water. Alexus services uses the more recent machine.
Other procedures that may be used to treat kidney stones include:
When substances that are normally excreted through the kidneys remain in the urinary tract, they may crystallize and harden into a kidney stone. If the stones break free of the kidney, they can travel through, and get lodged 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 causing extreme pain as they travel through or become lodged in the urinary tract. The areas most prone to trapping kidney stones are the bladder, ureters, and urethra.
Most kidney stones that develop are small enough to pass without intervention. However, in about 20 percent of cases the stone is greater than 2 centimeters (about one inch) and may require treatment. Most kidney stones are composed of calcium; however, there are other types of kidney stones that can develop. Types of kidney stones include:
The body takes nutrients from food and converts them to energy. After the body has taken the food that it needs, waste products are left behind in the bowel and in the blood.
The urinary system keeps chemicals, such as potassium and sodium, and water in balance by removing a type of waste, called urea, from the blood. Urea is produced when foods containing protein, such as meat, poultry, and certain vegetables, are broken down in the body. Urea is carried in the bloodstream to the kidneys.
two kidneys - a pair of purplish-brown organs located below the ribs toward the middle of the back. Their function is to:
The kidneys remove urea from the blood through tiny filtering units called nephrons. Each nephron consists of a ball formed of small blood capillaries, called a glomerulus, and a small tube called a renal tubule. Urea, together with water and other waste substances, forms the urine as it passes through the nephrons and down the renal tubules of the kidney.
two ureters - narrow tubes that carry urine from the kidneys to the bladder. Muscles in the ureter walls continually tighten and relax forcing urine downward, away from the kidneys. If urine backs up, or is allowed to stand still, a kidney infection can develop. About every 10 to 15 seconds, small amounts of urine are emptied into the bladder from the ureters.
bladder - a triangle-shaped, hollow organ located in the lower abdomen. It is held in place by ligaments that are attached to other organs and the pelvic bones. The bladder's walls relax and expand to store urine, and contract and flatten to empty urine through the urethra. The typical healthy adult bladder can store up to two cups of urine for two to five hours.
urethra - the tube that allows urine to pass outside the body. The brain signals the bladder muscles to tighten, which squeezes urine out of the bladder. At the same time, the brain signals the sphincter muscles to relax to let urine exit the bladder through the urethra. When all the signals occur in the correct order, normal urination occurs.
When kidney stones become too large to pass through the urinary tract, they may cause severe pain and may also block the flow of urine. An infection may develop. Lithotripsy may be performed to treat certain types of kidney stones in certain locations within the urinary tract.
There may be other reasons for your physician to recommend lithotripsy. If you are unsure you should consult your physician.
You may want to ask your physician about the amount of radiation used during the procedure and the risks related to your particular situation. It is a good idea to keep a record of your past history of radiation exposure, such as previous scans and other types of x-rays, so that you can inform your physician. Risks associated with radiation exposure may be related to the cumulative number of x-ray examinations and/or treatments over a long period of time. Alexus services will use Ultrasound to pinpoint the stone wherever possible but in some instances the use of x-ray cannot be avoided.
Complications of lithotripsy may include, but are not limited to, the following:
Contraindications for lithotripsy include, but are not limited to, the following:
Patients with cardiac pacemakers should notify their physician. Lithotripsy may be performed on patients with pacemakers with the approval of a cardiologist and using certain precautions. Rate-responsive pacemakers that are implanted in the abdomen may be damaged during lithotripsy.
There may be other risks depending upon your specific medical condition. Be sure to discuss any concerns with your physician prior to the procedure.
Obesity and intestinal gas may interfere with a lithotripsy procedure. Again your physician should be consulted if you have a concern.
Lithotripsy may be performed on an outpatient basis or as part of your stay in the hospital. Procedures may vary depending on your condition and your and your physician’s practices.
Generally, lithotripsy follows this process:
After the surgery you will be taken to the recovery room for observation. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room or discharged home.
You may resume your usual diet and activities unless your physician advises you differently.
You will be encouraged to drink extra fluids to dilute the urine and reduce the discomfort of passing stone fragments.
You may notice blood in your urine for a few days or longer after the procedure. This is normal.
Take a pain reliever for soreness as recommended by your physician. Aspirin or certain other pain medications may increase the chance of bleeding. Be sure to take only recommended medications. Consult your physician about this.
You may be given antibiotics after the procedure. Be sure to take the medication exactly as prescribed.
You may be asked to strain your urine so that remaining stones or stone fragments can be sent to the lab for examination.
A follow-up appointment will be scheduled within a few weeks after the procedure. If a stent was placed during the procedure, it may be removed at this time.
Notify your physician to report any of the following:
Your physician may give you additional or alternate instructions after the procedure, depending on your particular situation.