Lithotripsy is a non-invasive procedure followed to treat kidney stones that are too large to pass through the urinary tract. If the medications do not help to pass out the stones through the urinary tract, lithotripsy is followed to break down the larger stones into smaller ones to pass through the urine.
Lithotripsy was introduced in the early 1980s, which has changed the treatment modality and impact to a greater extent. Before introducing lithotripsy, patients had to undergo major surgical procedures to remove stones, but after the introduction of lithotripsy, the procedure was non-invasive, which means no cutting or insertion of telescopic machines was needed. It became the safest and most effective treatment option from then onward.
What Are the Types of Lithotripsy?
Different types of lithotripsy procedures are followed; they include :
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Extracorporeal Shock Wave Lithotripsy (ESWL): This technique uses shock waves that create pressure on kidney stones and break them into smaller pieces. It is the most common lithotripsy procedure that is followed. This shock wave lithotripsy procedure helps reduce the pain and discomfort caused by kidney stones and helps avoid surgery to remove stones.
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Electrohydraulic Lithotripsy (EHL): This type of lithotripsy uses shock waves to break down kidney stones so that smaller pieces can pass through the urinary tract. This procedure requires general anesthesia.
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Ultrasonic Lithotripsy: The probe transmits high-frequency sound waves to the kidney stone, where the ultrasonic waves strike the stones without causing damage to the surrounding tissues and organs.
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Laser Lithotripsy: Laser lithotripsy uses a pulsed dye laser of 540 nm (five hundred and forty nanometers) of light delivered through optical quartz fibers. The laser fragments the stone with a photoacoustic effect.
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Endoscopic Lithotripsy: This type of lithotripsy uses visualization of calculus or stone in the urinary tract and simultaneous application of energy to break the stones.
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Mechanical Lithotripsy: It is the most economical lithotripsy done by a pneumatic, mechanical device called lithoclast. This procedure is mainly used in managing larger and harder stones.
How Long Is the Lithotripsy Procedure?
The time taken for the lithotripsy procedure depends on the type of lithotripsy technique and the number of stones present. It ranges from thirty minutes to one hour. Usually, patients are discharged the same day after the procedure.
How Is the Treatment Procedure for Lithotripsy Conducted?
Lithotripsy is usually done in the hospital itself. This means the patient is required to visit the hospital or clinic on the day of the procedure. Before the procedure, they are made to change into a hospital dressing gown and asked to lie down on the examination table on a soft, cushioned pillow. This is where the procedure is performed. Sedation (anesthesia) and antibiotics are given to fight the infection. The strongest waves will pass through the body during lithotripsy and reach the kidney stones. Waves will break up stones into smaller particles that can be quickly passed out through the urinary system. After the procedure, the patient will spend about two hours recovering before being sent home. In some cases, they may be hospitalized overnight. Plan to spend one or two days relaxing at home after the procedure.
What Are the Indications for Lithotripsy?
Lithotripsy is indicated as follows :
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When kidney stones are large and block urine flow and cause severe pain.
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When an infection is developed.
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When there is bleeding and pain.
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Indicated when the stones are not too large and are seen on X-ray.
What Are the Advantages and Disadvantages of Lithotripsy?
Advantages :
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Most of the stones are fragmented and can be passed through the urine.
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It does not require long-term hospitalization. As a result, cost and recovery time are reduced.
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Non-invasive and well-tolerated procedure.
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Most of the stones can be treated safely.
Disadvantages :
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A pre-procedural stent may be required in some cases and treated with extra pectoral shock wave therapy.
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Results of larger stones may not be great in some cases compared to smaller stones.
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Lithotripsy may require more than one session, depending on the number and size of the stones.
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It cannot be done in patients with bleeding disorders and pregnant women.
What Are the Risks and Side Effects of Lithotripsy?
The possible risks or side effects that may be experienced after the procedure are:
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People often experience bruises and pain after a lithotripsy wave shock.
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Fever or chills may occur after the shock wave lithotripsy. This may indicate an infection, so one should talk to a doctor immediately.
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Severe bleeding after lithotripsy may occur but is rare, and if it happens, the person might need a blood transfusion.
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If pieces of stone are trapped, there may be a blockage in the ureter. Therefore, the doctor may perform an additional procedure with a ureteroscope to remove the fragments.
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Chronic pain may indicate obstruction. And if a person has severe pain or does not get relief from taking pain medication, they should consult a physician.
What Precautions Should One Take Before Lithotripsy?
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Clarify all queries and doubts with the physician without hesitating. It is better to be well-inormed about the procedure one will undergo and share fears or previous bad experiences with the doctor so that the doctor gets to know the patient better and can plan the procedure accordingly to be safe and successful.
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Patients must inform the doctor if they are pregnant or suspect pregnancy, as the lithotripsy procedure is contraindicated in pregnancy since it may harm the unborn baby.
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Notify the doctor in case of allergies to any medications, latex, or anesthetic substances.
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Patients who are being treated for other diseases, taking blood thinners like Aspirin, or with a history of bleeding disorders should inform their doctor of the same.
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Having a bystander along is ideal, as the procedure involves sedation, and it would be better to be driven back home.
Conclusion:
Even though lithotripsy is non-invasive and takes less time, the recovery time depends on the overall health condition, how well the patient follows the post-care instructions, and the number of stones present. The patient should be prepared to experience some pain because stones passing through urine can hurt. Doctors usually prescribe medications to reduce this pain. However, if it does not go away even after taking pain medication or the patient experiences symptoms like bleeding, fever, or chills, immediately seek the help of the doctor. Following the dietary recommendations and post-operative care procedures precisely can help prevent the recurrence of stones.
