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Extracorporeal Shock Wave Lithotripsy for Kidney Stones


Why is this procedure done?


The urinary tract is made up of the kidney, ureters, bladder, and urethra. The kidneys make urine and it drains down into tubes called ureters. These ureters are connected to the bladder. The bladder then squeezes out the urine and it exits the body through the urethra. ‚  
Sometimes, salts and minerals in your urine build up and form stones. The stones are hard and can get stuck on their way out of the body. Some stones are too large and block the flow of urine. Others cause bleeding and pain. They may damage the kidney. These stones need a procedure to break them up. ‚  
Kidney stones may be broken up without cutting the skin. A special procedure called extracorporeal shock wave lithotripsy is used to break the stone down into tiny sand-like pieces. ‚  


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What will the results be?


The kidney stones will easily pass through the urinary tract and out of the body as very small sand-like pieces. ‚  

What happens before the procedure?


  • Your doctor will take your history. Talk to your doctor about:
    • All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
    • Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin ‚ ®, ibuprofen, Aleve ‚ ® (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
    • When you need to stop eating or drinking before your procedure.
  • Your doctor will do an exam and may order:
    • Lab tests
    • X-rays
    • Ultrasound
    • CT or MRI scan
  • You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home.

What happens during the procedure?


  • Once you are in the operating room, the staff will put an I.V. in your arm to give you fluids and drugs. You will be given a drug to make you sleepy. It will also help you stay pain free during the surgery.
  • The doctor will position you on your side, stomach, or on your back to get the best view of the stone. Your doctor may put a gel on your skin. This gel will help conduct the shock waves into your body. You may also be lying on a soft-water filled cushion or sitting in a tub of water.
  • If the kidney stone is too close to where urine exits, your doctor may use a small tool to push the stone back into the kidney.
  • The probe will make shock waves that will pass through your body. You might feel some discomfort while the probe is moving.
  • Your doctor may put a small plastic tube inside your urethra. This tube will help big pieces of the kidney stones pass through the urinary tract. This will help stop a blockage in your urinary tract.
  • The procedure takes about 1 hour.

What happens after the procedure?


  • You will stay to recover for up to 2 hours after the procedure. You may go home when you have fully recovered or when the doctor tells you.
  • You may feel some stinging pain on your skin after the procedure. Your doctor will give you drugs for pain relief.
  • If you have an I.V. line, your doctor may give more fluids to help flush out the pieces of stone.
  • Your doctor may give you drugs to prevent infection. Take as your doctor ordered by your doctor.
  • You will have blood in your urine for a few days.
  • You will have cramping for a few days.

What drugs may be needed?


The doctor may order drugs to: ‚  
  • Help with pain
  • Prevent infection
  • Relax smooth muscles in your ureter to help flush out kidney stones
  • Prevent kidney stones

What problems could happen?


  • Pain while pieces of the kidney stone pass
  • Blocked urine flow if stone fragments are too big to pass
  • Kidney injury
  • High blood pressure
  • Urinary tract infection
  • Blood in the urine
  • Bruising
  • Discomfort in the back or belly

What can be done to prevent this health problem?


  • Prevent or treat urinary tract infections.
  • Drink lots of water during the day and evening. When you have less fluid in your body, urine becomes concentrated. This increases your chance of kidney stones.
  • Follow the diet plan your dietitian gives you to prevent kidney stones.
  • Limit foods or drugs that may cause kidney stones.

Where can I learn more?


American Urological Association Foundation ‚  
http://www.urologyhealth.org/urology/index.cfm?article=148 ‚  
National Kidney and Urologic Diseases Information Clearinghouse ‚  
http://kidney.niddk.nih.gov/kudiseases/pubs/stones_ez/ ‚  
National Kidney Foundation ‚  
http://www.kidney.org/atoz/content/kidneystones_ShockWave.cfm ‚  

Consumer Information Use and Disclaimer


This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚  

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