Lithotripsy

• Alternative Names

  Extracorporeal shock wave lithotripsy; Shock wave lithotripsy; Laser lithotripsy; Percutaneous lithotripsy; Endoscopic lithotripsy; ESWL

• Description

  Extracorporeal shock wave lithotripsy (ESWL) is the most common type of lithotripsy. "Extracorporeal" means outside the body.

  You will wear a medical gown and lie on an exam table on top of a soft, water-filled cushion. You will be given a mild sedative or pain medicine before the procedure starts. You will also be given antibiotics before the procedure starts to prevent infection.

  High-energy shock waves, also called sound waves, will pass through your body until they hit the kidney stones. You may feel a tapping sensation when this starts. The waves break the stones into tiny pieces.

  The lithotripsy procedure generally takes 45 minutes to 1 hour.

  A tube may be placed through your back and into your kidney. This tube will drain urine from your kidney until all the small pieces of stone pass out of your body. The tube may be put in place before or after your lithotripsy treatment.

  See also: Percutaneous urinary procedures

• Why the Procedure Is Performed

  Lithotripsy is used to remove kidney stones that are causing:

  • Pain
  • Urinary tract infections
  • Bleeding
  • Harm to your kidney
• Risks

  Lithotripsy is generally safe. Ask your doctor about these possible complications.

  • Pieces of stone are left in your body. You may need more treatments.
  • Bleeding around your kidney may require a blood transfusion.
  • Your kidney(s) may not work as well, or they may stop working, after the procedure.
  • You may get ulcers in your stomach or small intestine.
  • Pieces of the stone may block urine flow from your kidney. This may cause severe pain or damage to your kidney.
  • Kidney infection may occur.
• Before the Procedure

  Always tell your doctor or nurse:

  • If you are or could be pregnant
  • What drugs you are taking, even drugs, supplements, or herbs you bought without a prescription

  During the days before the surgery:

  • You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), and any other drugs that make it hard for your blood to clot. Ask your doctor when to stop taking them.
  • Ask your doctor which drugs you should still take on the day of the surgery.

  On the day of your procedure:

  • You will usually be asked not to drink or eat anything for several hours before the procedure.
  • Take the drugs your doctor told you to take with a small sip of water.
  • Your doctor or nurse will tell you when to arrive at the hospital.
• After the Procedure

  After the procedure, you will stay in the recovery room for up to about 2 hours. Most people are able to go home the day of their procedure.

• Outlook (Prognosis)

  How well you do depends on the number of stones you have, their size, and where in your urinary system they are. Usually, lithotripsy completely removes the stones.

• References

  Lingeman JE, Matlaga BR, Evan AP. Surgical management of upper urinary tract calculi. In: Wein AJ, ed. Campbell-Walsh Urology, 9th ed. Philadelphia, PA: Saunders; 2007:chap 44.

  Wen CC, Nakada SY. Treatment selection and outcomes: renal calculi. Urol Clin North Am. 2007;34(3):409-419.

Review Date: 1/15/2009

Reviewed By: Louis S. Liou, MD, PhD, Assistant Professor of Urology, Department of Surgery, Boston University School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.