Lithotripsy

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Intravenous pyelogram (IVP)

Kidney anatomy

Lithotripsy procedure

Nephrolithiasis

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

There are several forms of lithotripsy. The most common is extracorporeal shock wave lithotripsy (ESWL). Extracorporeal means outside the body.

You will usually be asked not to drink or eat anything for several hours before the test. Before the test is scheduled, tell your health care provider about any medicines you take. You may be asked to stop taking aspirin, ibuprofen, coumadin, and any other drugs that interfere with blood clotting several days before. You should tell your doctor if you are pregnant, because lithotripsy must not be performed during pregnancy.

You will wear a medical gown and lie down on an exam table on top of a soft, water-filled cushion. (Older machines required the person to sit in a tub filled with water. Although this isn't done much anymore, the method works, and some machines are still available today.) Since lithotripsy can cause mild discomfort, you will be given a mild sedative or painkiller before the procedure starts.

The health care provider will use x-ray or ultrasound images to see where the stones are. High-energy shock waves, also called sound waves, pass through your body to the area on the kidney stones. You may feel a tapping sensation when this starts. The waves break the stones into tiny pieces. It is easier for smaller pieces to pass out of the body during urination.

The procedure generally takes from 45 minutes to 1 hour.

ESWL is an alternative to surgery that is sometimes needed to remove stones from the kidney or ureter. Because ESWL requires no cutting, you have less pain and a quicker recovery. An overnight hospital stay is usually not needed.

While most kidney stones are treated with ESWL, not all stones can be treated this way. Sometimes a laser is used. When a laser is used, the doctor must use an endoscope, which is a tube introduced into the body, via the urinary tract, to get close to the stone. This usually requires general anesthesia (asleep, no pain), but you may go home the same day. Laser lithotripsy may be done if stones do not go away with ESWL, if they can't be treated with ESWL, or if you can not have ESWL for some reason. Laser lithotripsy carries a slightly greater risk of complications than extracorporeal shock wave lithotripsy.