Lithotripsy

Definition

Lithotripsy is a procedure that uses shock waves to break up stones in the kidney and parts of the ureter (tube that carries urine from your kidneys to your bladder). After the procedure, the tiny pieces of stones pass out of your body in your urine.

Alternative Names

Extracorporeal shock wave lithotripsy; Shock wave lithotripsy; Laser lithotripsy; Percutaneous lithotripsy; Endoscopic lithotripsy; ESWL; Renal calculi-lithotripsy

Description

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

To get ready for the procedure, you will put on a hospital gown and lie on an exam table on top of a soft, water-filled cushion. You will not get wet.

You will be given medicine for pain or to help you relax before the procedure starts. You will also be given antibiotics.

When you have the procedure, you may be given general anesthesia for the procedure. You will be asleep and pain-free.

High-energy shock waves, also called sound waves, guided by x-ray or ultrasound, will pass through your body until they hit the kidney stones. If you are awake, you may feel a tapping feeling when this starts. The waves break the stones into tiny pieces.

The lithotripsy procedure should take about 45 minutes to 1 hour.

A tube called a stent may be placed through your back or bladder into your kidney. This tube will drain urine from your kidney until all the small pieces of stone pass out of your body. This may be done before or after your lithotripsy treatment.

Why the Procedure Is Performed

Lithotripsy is used to remove kidney stones that are causing:

Not all kidney stones can be removed using lithotripsy. The stone may also be removed with:

Risks

Lithotripsy is safe most of the time. Talk to your health care provider about possible complications such as:

Before the Procedure

Always tell your provider:

During the days before the surgery:

On the day of your procedure:

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. You will be given a urine strainer to catch the bits of stone passed in your urine.

Outlook (Prognosis)

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

References

Bushinsky DA. Nephrolithiasis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 117.

Matlaga BR, Krambeck AE. Surgical management of upper urinary tract calculi. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 94.

Zumstein V, Betschart P, Abt D, Schmid HP, Panje CM, Putora PM. Surgical management of urolithiasis - a systematic analysis of available guidelines. BMC Urol. 2018;18(1):25. PMID: 29636048 pubmed.ncbi.nlm.nih.gov/29636048/.


Review Date: 7/26/2021
Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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