Kidney Stones: Treatment with Lithotripsy

First Published: January 2004
Last Revised: January 2004
Peer Review Status: Internally Peer Reviewed

Lithotripsy is generally performed on an outpatient basis, often using sedation, but most frequently under a general anesthetic. The process uses a device called a lithotriptor. Because all the energy is generated by a machine outside the body and no incisions are made, the process is called Extracorporeal Shock Wave Lithotripsy (ESWL). This treatment can be used to break stones located in the kidney or in the ureter. Stones that are larger than 2 centimeters may be too large to fully break up with one treatment, and might be better treated by some other method, including open surgery. ESWL can be used in adults and in children, but care must be used to avoid injuring adjacent organs, such as the lungs, in children.

Lithotriptors generate shock waves by various mechanisms but all fragment stones based on the same principles. Shock waves travel easily through the soft tissues of the body with minimal damage to surrounding structures, but are focused on the kidney stones. The stones absorb the energy from these waves and break up. Small stone fragments are then passed in the urine. The treatment is rarely painful, but passing the stone fragments may be.

Depending of the location and size of the stone, as well as the number of fragments produced, your doctor may or may not place a stent in your ureter (the tube that connects the kidney to the bladder to drain urine). A stent is a small tube that allows the kidney to drain into the bladder and the stones to pass around the tube. The stent is located entirely on the inside and will have to be removed in the clinic at a later time. Removal of the stent is done without anesthesia, and is slightly uncomfortable, but takes only about 1 minute.

Kidney stones are crystalline masses that form from minerals and proteins in the urine. Stones come in various sizes and compositions. Certain types of stones will respond to this treatment better than others. Most kidney stones are very small, less than one-quarter of an inch, and pass without the need for lithotripsy or any other treatment.

If you have kidney stones that are too large to pass, lithotripsy may make removal fairly simple. Your recovery time will be much shorter than with surgery. However, this procedure does not alter the reasons that the stones formed. To prevent future stones, follow the therapy and dietary changes that your healthcare provider suggests. The most important suggestion will be a large fluid intake, which results in a lot of urine output and dilution of the chemicals which may produce stones.

See related Patient Textbooks about Urology.

See related Patient Topics Kidney Stones, Kidneys and Urinary System or Urology.

See related Provider Textbooks about Urology.

See related Provider Topics Kidneys and Urinary System or Urology.

All contents copyright © 1992-2004 the Author(s) and The University of Iowa. All rights reserved.

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