Lithotripsy For Kidney Stones: How Is It Done?

Kidney stones can be a real challenge, quite an ordeal most often, and individuals tend to look for the best solution to get rid of the problem. Lithotripsy is one that is most often suggested; this is a non-invasive treatment pioneered to shatter the kidney stones into smaller particles that can be passed out naturally. But how does it really work and what will these steps look like?

In this Kidney stone blog, we’ll take a closer look at the lithotripsy procedure and what makes it ideal for anyone battling kidney stones. If you have been recently diagnosed, or if you are still gathering information on your potential treatments, then learning about the surgery could give you that extra boost in confidence knowing what to expect in the future.

What is Lithotripsy?

Lithotripsy is a medical procedure designed to treat kidney stones or other stones in the urinary tract by breaking them into smaller, more manageable pieces. This helps the body pass the stones naturally through urine, alleviating pain and preventing complications like infections or blockages. The procedure is typically recommended when the stones are too large to pass on their own or cause severe symptoms such as persistent pain, blood in the urine, or recurrent urinary tract infections.

Types of Lithotripsy

1. Extracorporeal Shock Wave Lithotripsy (ESWL):
   • How It Works:
     This is the most common type of lithotripsy. It uses high-energy shock waves generated outside the body to target and break up stones into smaller fragments. The shock waves are focused on the stone using imaging guidance (X-rays or ultrasound).
   • Procedure Details:
     ESWL is non-invasive, meaning no incisions or internal instruments are used. Patients typically lie on a water-filled cushion or are positioned to ensure precise targeting of the stones. The procedure takes about 45 minutes to an hour and is usually performed on an outpatient basis.
   • Recovery:
     Recovery is quick, but patients may experience mild side effects like bruising on the skin, blood in the urine, or discomfort as the stone fragments pass.
2. Laser Lithotripsy:
   • How It Works:
     This procedure involves the use of a ureteroscope—a thin, flexible tube equipped with a camera and laser fiber. The ureteroscope is inserted through the urethra and guided to the stone. A laser is then used to break the stone into smaller pieces.
   • Procedure Details:
     Laser lithotripsy is minimally invasive and often performed under general or spinal anesthesia. It is highly effective for stones located in the ureter or bladder.
   • Recovery:
     Most patients can return to normal activities within a few days. Some may experience mild discomfort or a burning sensation during urination as the fragments pass.
3. Ultrasound Lithotripsy (Intracorporeal Lithotripsy):
   • How It Works:
     This method uses high-frequency sound waves delivered through a probe inserted into the urinary tract. The vibrations from the sound waves fragment the stones.
   • Procedure Details:
     Ultrasound lithotripsy is typically performed in conjunction with other procedures like percutaneous nephrolithotomy (PCNL) for larger or more complex stones.
   • Recovery:
     Recovery time may vary depending on the extent of the procedure, but most patients experience minimal discomfort.

When is Lithotripsy Recommended?

Lithotripsy is not a first-line treatment for every case of kidney or urinary stones. It is typically recommended when the stones cause significant discomfort or complications that cannot be managed through conservative measures such as increased fluid intake, pain relievers, or medications to help pass the stones. 

Below are the specific scenarios where lithotripsy becomes a preferred option:

1. Kidney or Ureteral Stones Larger Than 5-6 mm

• Why Size Matters:
  Smaller stones (less than 5 mm) often pass naturally through the urinary tract without intervention. However, stones larger than 5-6 mm may be too big to pass on their own, leading to prolonged pain and potential complications.
• Impact of Large Stones:
  Large stones can block the flow of urine, increasing the risk of infection, kidney damage, or the formation of additional stones. Lithotripsy is effective in breaking these stones into smaller, passable fragments.

2. Severe Pain (Renal Colic)

• Understanding Renal Colic:
  Renal colic refers to intense, cramping pain caused by stones moving through the urinary tract or obstructing the flow of urine. This pain typically radiates from the lower back to the groin and is often described as one of the most severe types of pain.
• When Pain Management Alone Isn’t Enough:
  If the pain is persistent and cannot be controlled with medication, lithotripsy may be recommended to quickly alleviate the source of discomfort by breaking down the obstructing stone.

3. Obstructions in the Urinary Tract

• How Obstructions Occur:
  Stones can block the urinary tract at various points, including the ureter, kidney, or bladder, preventing urine from flowing freely. This can lead to a backup of urine, increasing pressure in the kidneys and causing swelling (hydronephrosis).
• Risks of Prolonged Obstruction:
  Prolonged obstructions can lead to kidney damage, infections, and reduced kidney function. Lithotripsy is often used to clear the blockage, restoring normal urinary flow and preventing long-term complications.

4. Recurrent Urinary Tract Infections (UTIs)

• Stones as Infection Triggers:
  Stones can create an environment conducive to bacterial growth, leading to recurrent urinary tract infections. The rough surfaces of the stones can harbor bacteria, making it difficult to fully eliminate the infection with antibiotics alone.
• Why Lithotripsy Helps:
  By removing or breaking down the stones, lithotripsy eliminates the underlying cause of the recurrent infections, reducing the risk of future episodes.

5. Blood in the Urine (Hematuria)

• What Causes Hematuria in Stone Patients:
  Stones can irritate the delicate lining of the urinary tract, leading to bleeding. This may present as visible blood (gross hematuria) or be detected only under a microscope (microscopic hematuria).
• When Lithotripsy is Needed:
  If bleeding persists or is associated with other complications like pain or obstruction, lithotripsy may be recommended to remove the stones and stop the irritation.

How is lithotripsy done to remove kidney stones?

Lithotripsy is a non-invasive procedure used to break down kidney stones into smaller fragments, making it easier for your body to pass them naturally. It’s often recommended when stones are too large to pass on their own or cause severe pain and discomfort.

Here’s How It Works:

1. Preparation: You’ll lie on a table or in a water bath, depending on the type of lithotripsy. Most commonly, Extracorporeal Shock Wave Lithotripsy (ESWL) is used. Before the procedure, you might receive mild sedation or pain medication to keep you comfortable.
2. Shock Waves Target the Stones: The doctor uses imaging techniques like X-rays or ultrasound to precisely locate the kidney stones. Once positioned, shock waves are directed at the stones from outside your body. These high-energy waves break the stones into smaller pieces.
3. After the Procedure: Once the stones are fragmented, they pass through your urinary tract over the following days or weeks. You may experience mild discomfort or notice blood in your urine, which is normal as the stones exit your body.

Recovery and What to Expect

Lithotripsy is typically an outpatient procedure, meaning you can go home the same day. Recovery time is relatively quick, and most people can resume their normal activities within a few days. Drinking plenty of water helps flush out the fragments and keeps your urinary system healthy.

While lithotripsy is effective for many, it may not be suitable for everyone, particularly if stones are too large, hard, or located in tricky areas. Always consult your doctor to determine the best treatment plan for your condition.

Break Free from Kidney Stones with CureStone

Choose CureStone for your lithotripsy treatment and experience expert care with Dr. Deepanshu Gupta, a renowned urologist. With advanced technology and personalized attention, we ensure a smooth, effective, and comfortable path to recovery. Your health is our priority.

At CureStone, we believe in providing comprehensive care, from diagnosis to post-treatment follow-ups. Dr. Gupta’s expertise, combined with our state-of-the-art facilities, ensures precise treatment and long-term relief. Don’t let kidney stones disrupt your life—trust us for a pain-free solution.