LITHOTRIPSY

General Information

DEFINITION-A technique to crush kidney stones inside the body without a surgical incision. These stones are too large to pass by normal elimination. Seventy percent of patients pass stones spontaneously, 30% require urological treatment. This technique is one of the available treatments.

BODY PARTS INVOLVED-Kidney; ureter; bladder.

REASONS FOR SURGERY-Kidney stones that are too large to pass by normal elimination. They are usually lodged in the kidney or upper third of the ureter.

SURGICAL RISK INCREASES WITH

• Childhood.
• Poor heart or respiratory function.
• Presence of a cardiac pacemaker.
• Pregnancy.
• Bleeding disorders.
• Taking anticoagulants or aspirin.

What To Expect

WHO OPERATES-Urologist.

WHERE PERFORMED-A special center for lithotripsy. Usually in an outpatient surgical facility of a regional referral center.

DIAGNOSTIC TESTS

• Before surgery: Cystoscopy (see in Surgery section), x-rays, blood and urine studies.
• During surgery: Cystoscopy, x-rays.
• After surgery: Blood and urine studies, x-rays, ultrasound.

ANESTHESIA

• Varies according to condition of patient.
• General anesthesia by injection and inhalation with an airway tube placed in the windpipe.
• Spinal anesthesia.

DESCRIPTION OF OPERATION

• For one method, the patient rests in a tub of warm water after being sedated or anesthetized. Another method avoids the water by using a membrane coupling device applied directly to the skin overlying the kidney.
• A ureteral catheter is inserted to help locate the stone.
• The lithotripsy unit sends out high frequency sound waves directed toward the stone. The shock waves pulverize the stones and the small particles pass spontaneously over 2-5 days.

POSSIBLE COMPLICATIONS

• May require more than 1 treatment.
• Cell damage to kidney, pancreas, liver, muscle, gastrointestinal tract.

AVERAGE HOSPITAL STAY-1 to 2 days.

PROBABLE OUTCOME-Mild pain as fragments of stone pass.

Postoperative Care

GENERAL MEASURES

• No smoking.
• Soak in tub of warm water once or twice a day to relieve mild back pain.
• Strain urine for 1 to 2 weeks. Place fragments in envelope to return to lithotripsy center or as directed.

† You may use non--

prescription drugs, such as acetaminophen, for minor pain.

• Avoid aspirin.

ACTIVITY

• Resume normal activity as soon as possible to promote healing.
• Take mild exercise.

DIET---Your doctor may recommend a special diet to help prevent recurrence of stones.

Call Your Doctor If

† You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.

• You experience nausea, vomiting, constipation or abdominal swelling.
• Your temperature rises to 101F (38.3C).
• there is blood or pus in your urine or urination is frequent and painful.