Lithotripsy: Types, Indications, Procedure and Recovery
Lithotripsy is a non-invasive medical procedure used to break down kidney stones or urinary tract stones into smaller fragments. This procedure is performed using shock waves that are targeted at the stones, causing them to fragment and eventually pass out of the body through urine.
Lithotripsy eliminates the need for surgical intervention to remove kidney stones. It is an effective and less invasive way to treat stones that are causing pain, obstruction, or infection in the urinary system.
Types of Lithotripsy
There are different types of lithotripsy used to break down kidney and urinary tract stones based on stone size, location, and patient condition.
- Extracorporeal Shock Wave Lithotripsy (ESWL) – Uses shock waves to break stones into smaller fragments for natural passage.
- Laser Lithotripsy – Utilizes laser energy to fragment stones during ureteroscopy.
- Percutaneous Lithotripsy (PCNL) – A minimally invasive procedure to remove large or complex stones through a small incision.
- Electrohydraulic Lithotripsy (EHL) – Uses high-energy hydraulic pulses to break down stones, often performed during endoscopic procedures.
Each type of lithotripsy is chosen based on stone characteristics and patient health for effective treatment.
Indications of Lithotripsy Procedure
Lithotripsy indications include various conditions where kidney or urinary tract stones cause significant symptoms or complications. Lithotripsy procedure is recommended for:
- Kidney Stones Causing Pain: When stones lead to severe discomfort or renal colic.
- Obstruction in the Urinary Tract: Stones blocking urine flow, leading to swelling or kidney damage.
- Recurrent Urinary Tract Infections (UTIs): Stones contributing to repeated infections.
- Non-Responsive to Medication: When stones do not dissolve or pass naturally with conservative treatment.
- Moderate-Sized Stones: Typically effective for stones between 4mm and 20mm in size.
Lithotripsy indications are determined based on stone size, location, composition, and patient health, ensuring an effective, non-invasive treatment approach.
Who Will Treat for Lithotripsy?
Lithotripsy is performed by medical specialists who diagnose and treat kidney stones and urinary tract conditions.
- Urologists
- Nephrologists
- Primary Care Physicians
- Interventional Radiologists
Preparing for Lithotripsy Surgery Procedure
Lithotripsy preparation involves a combination of medical evaluations, instructions, and communication with your healthcare team:
- Medical Evaluation: Your urologist will assess your medical history, perform physical examinations, and may order imaging tests (such as CT scans) to determine the size and location of the stones.
- Medication Review: Inform your urologist about any medications you are taking, including prescription drugs, over-the-counter medications, and supplements. Some medications may need to be adjusted before the procedure.
- Hydration: Stay well-hydrated before the procedure, as this can help improve the effectiveness of lithotripsy.
- Fasting: You may be instructed to fast for a certain period before the procedure, especially if general anesthesia is used.
- Anesthesia Discussion: Depending on the type of lithotripsy used, you may be administered general anesthesia, sedation, or remain awake during the procedure. Your healthcare team will discuss your options with you.
- Clothing and Comfort: Wear comfortable clothing to the procedure and follow any specific instructions provided by your healthcare team.
- Coordination: Arrange for someone to accompany you to the procedure and to drive you home afterward, especially if you receive sedation or anesthesia.
- Communication: If you have any questions or concerns about the procedure, don’t hesitate to communicate with your healthcare team.
What Happens During Lithotripsy Surgery Procedure?
During lithotripsy, shock waves are used to break down kidney stones or urinary tract stones. Here’s an overview of the Lithotripsy procedure:
- Positioning: You will be positioned on a treatment table, usually lying on your back. The treatment area will be carefully positioned in alignment with the lithotripsy device.
- Anesthesia: Depending on the type of lithotripsy used, you may receive general anesthesia, sedation, or remain awake during the procedure. Your healthcare team will discuss the anesthesia options with you.
- Imaging: Imaging techniques, such as ultrasound or fluoroscopy, may be used to precisely locate the stones within your urinary tract.
- Shock Wave Delivery: The lithotripsy device generates shock waves, which are focused on the location of the stone. These shock waves are delivered externally through the skin. You may feel a tapping or knocking sensation as the shock waves hit the stone.
- Stone Fragmentation: The shock waves travel through the body and break the stone into smaller fragments. These smaller pieces are easier to pass through the urinary system.
- Monitoring: The procedure is monitored using imaging to ensure the stones are being effectively fragmented.
- Post-Procedure Evaluation: After the procedure, your healthcare team may perform imaging to assess the success of stone fragmentation and check for any remaining fragments.
Lithotripsy is a non-invasive procedure, meaning no surgical incisions are made. The procedure duration can vary based on the size and location of the stones.
Risks of Lithotripsy Procedure
While lithotripsy is a safe and non-invasive procedure, it may involve certain risks and complications.
- Pain and discomfort
- Blood in urine (Hematuria)
- Infection
- Incomplete stone fragmentation
- Kidney or ureteral injury
- Urinary tract blockage
Recovery After Lithotripsy Surgery Procedure
Lithotripsy Recovery is generally straightforward and involves the following steps:
- Observation: If sedation or anesthesia was used, you’ll be observed in a recovery area until you’re awake and stable.
- Pain Management: You may experience some discomfort or mild pain after the procedure. Your healthcare team will provide pain relief instructions.
- Hydration: Drinking plenty of water helps flush out the stone fragments from your urinary system.
- Physical Activity: Light physical activity can help promote the passage of stone fragments. However, avoid strenuous activities initially.
- Follow-Up: You’ll likely have a follow-up appointment with your urologist to assess the success of the procedure and monitor your recovery.
- Passing Stone Fragments: Over the following days or weeks, you may pass stone fragments in your urine. This is a normal part of the recovery process.
Lithotripsy recovery time varies for each individual, but most people resume normal activities within a few days.
Lifestyle Changes After Lithotripsy Surgery
Lifestyle adjustments can help prevent future stone formation and support your recovery:
- Hydration: Drink plenty of water to maintain proper hydration and promote the flushing of urinary tract system.
- Diet: Reduce intake of foods high in oxalate, such as spinach and chocolate, and limit sodium and animal protein intake. Consult your urologist for dietary recommendations.
- Citrus Fruits: Incorporate citrus fruits that contain citrate, which may help prevent stone formation.
- Moderate Calcium Intake: Consume an adequate amount of calcium-rich foods without excessive intake.
- Medication Adherence: If your urologist prescribes medications to prevent stone formation, take them as directed.
