What is Lithotripsy?
Lithotripsy is a medical procedure which uses powerful and precise sonic shock waves to disintegrate kidney stones, bladder stones and stones in the ureter, the tube which carries urine from the kidneys to the bladder. Once the procedure breaks up the stone, the smaller pieces are easily passed out from the body through the urine.
Lithotripsy may also be known as:
Extracorporeal shock wave lithotripsy
Shock wave lithotripsy
How is Lithotripsy performed?
ESWL (extracorporeal shock wave lithotripsy) is the most commonly used lithotripsy technique. The term ‘extracorporeal’ refers to it being performed from outside the body without the need of incisions.
The surgeon will administer mild sedative or painkiller before the procedure to numb any pain and prevent discomfort during the procedure. Antibiotics are also given to prevent risk of infection.
The surgeon will use an advanced medical device which is capable of transmitting high-energy sound waves which easily pass through the body to strike the stones in the kidney, bladder or ureter. A tapping sensation may be felt when the procedure begins. The powerful sonic waves easily break the stones into tiny pieces.
The entire lithotripsy procedure may take anywhere from 45 to 60 minutes normally. The surgeon may also place a catheter in the kidney, through the back. This tube helps to drain the kidney of urine and any excess fluid, along with the broken pieced of kidney stones. The surgeon may attach the catheter before or right after the lithotripsy procedure.
Why is Lithotripsy needed?
Lithotripsy procedure is needed to remove kidney stones which are likely to cause:
Urinary Tract Infections (UTI)
Damage to kidney
How is Lithotripsy helpful?
There are several different techniques used to perform a lithotripsy procedure. These are short procedures that are performed as outpatient procedures in hospitals and healthcare centers. Some may require general anesthesia while others can be performed using mild sedatives and painkillers. Apart from being a simple and highly successful procedure, lithotripsy also helps in faster recovery.
The exact procedure requires the patient to lie down in a water bath or on a cushion. The doctor will use an ultrasound or x-ray machine to locate the stone. The lithotripsy device transmits high-energy, yet precise, sound waves that cause the stones to vibrate minutely and shatter into very fine pieces. These pieces are small enough to be easily passed out of the body in the urine painlessly.
Are there any complications associated with Lithotripsy procedure?
As is seen in any medical procedure, there are certain risks associated with lithotripsy procedure as well. It is important to know about these before deciding to undergo the procedure.
Hematuria (blood in the urine) is one of the more common side effects of lithotripsy. This can be seen for a few days following the procedure. Avoid taking aspirin and other NSAIDs for a week to 10 days to prevent this.
At times, the remaining pieces of the disintegrated kidney stone may come in contact with the walls of the urinary tract and cause cramp-like pain as they pass in the urine. Once the pieces are completely flushed out of the body, this symptom will also subside. It is important for the kidney stones to be removed completely, as they may lead to formation of new stones otherwise.
In case it takes longer than expected for the stones to be removed completely from the body, the surgeon may insert a catheter (surgical tube) into the kidney, through a tine incision in the back.
People suffering from kidney abnormalities, such as renal cysts may face additional complications after this procedure.
When is Lithotripsy a good advice?
The lithotripsy procedure has the highest rate of success (around 90%) in removing kidney stones effectively and completely, as compared to other kidney stone removal procedures. This procedure is best-suited in removing stones that are less than ½ inches in size and is positioned in the upper part of the ureter, near the pelvic area of the kidney.
Depending on the size and type of kidney stone, lithotripsy procedure prevents about 65% to 75% of people from having to live with this painful disorder. Uric acid stones and calcium stones are best treated using this procedure. In case certain calcium stones do not disintegrate easily and pose problems with fragments left behind, this may lead to a success rate of about 40%. Smaller cystine stones are easier to treat, as compared to larger-sized stones. For Staghorn kidney stones, the success rate of lithotripsy is around 50% to 60%.
People with a single stone have a better success rate as compared to patients with multiple kidney stones. People with abnormally-shaped kidneys also benefit from this procedure.
People with severe health conditions, such as diabetes, heart disease, hyper-tension and breathing problems, also find it safe to undergo lithotripsy rather than conventional surgical removal of kidney stones.
However, lithotripsy is not advised for every patient who is suffering from kidney stones. However, the success rate far outweighs the inability to help with this procedure.
What is recovery like after an ESWL (Extracorporeal Shock Wave Lithotripsy) procedure?
In most cases, the ESWL procedure is performed as on outpatient procedure where the patient is usually allowed to go home the same day. As this procedure is non-invasive and does not require incisions, the recovery is remarkably faster as well. Most patients can resume normal everyday activities a few days after the procedure.
Lithotripsy Surgery in India
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