What is Lithotripsy?

Mary McMahon

Lithotripsy is a procedure in which kidney stones are broken up with shock waves so that a patient can pass them when he or she urinates. This procedure is an alternative to surgery for kidney stones, and it can be very effective, especially in cases where the stones are still in the kidneys. When a lithotripsy is ordered, a patient should plan to set aside a few hours for the procedure, and some special preparations are required on the part of the patient to ensure that it goes smoothly.

An ultrasound may be used to detect kidney stones.
An ultrasound may be used to detect kidney stones.

In extracorporeal shock wave lithotripsy (ESWL), the kidney stones are broken up from outside the body with the use of a targeted shock or sound wave. Laser lithotripsy requires the insertion of a device into the ureter for the purpose of aiming at and breaking up the kidney stones. Both techniques are not safe for use in pregnant patients, or patients with certain heart conditions or clotting disorders.

Lithotripsy provides a non-surgical means of breaking up kidney stones.
Lithotripsy provides a non-surgical means of breaking up kidney stones.

Before a lithotripsy can take place, the patient will be asked to refrain from eating or drinking for several hours before the procedure for safety. The patient's blood may also be tested to confirm that lithotripsy and the accompanying sedatives will be safe for the patient. At the time of the procedure, the patient will be sedated or anesthetized for comfort and carefully laid out on a table or bench with a water-filled cushion, or lowered into a tub of water. The water absorbs the shock from the wave energy, reducing reverberations.

Bloody urine that occurs after a lithotripsy should be reported to a doctor immediately.
Bloody urine that occurs after a lithotripsy should be reported to a doctor immediately.

The kidney stones are identified with the use of a tracer dye which is injected and followed with a medical imaging device. The dye accumulates around the stones, highlighting them so that it is easy to aim the lithotriper in the right place. Starting with a low power setting, the doctor gradually increases the intensity of the shock until the stones break up. Within a few days, the patient should pass the stones.

Kidney stones can be very painful.
Kidney stones can be very painful.

There are some risks to lithotripsy. The procedure can cause damage to the internal organs, resulting in internal bleeding or blockage. Sometimes the stones do not break up, which means that the patient will need to undergo a more aggressive intervention to address the problem, and patients may also experience urinary blockages or infections as a result of the lithotripsy or as a complication from passing the kidney stones. Patients should definitely report severe abdominal pain, difficulty urinating, or bloody urine to their doctor if these symptoms emerge after a lithotripsy.

A urinalysis may be conducted to detect kidney stones.
A urinalysis may be conducted to detect kidney stones.

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Discussion Comments


I had the procedure. It's day two and I haven't seen any stone fragments or sand like particles. I also feel a tightness, but not pain, under the rib cage. Did it work? how will I know other than through another xray or ct scan?


Following the procedure, expect pain, blood in the urine, as well as frequent urination. Try hot showers and a heating pad or cold when the pain is at its worst.


to answer post 1: I have had Lithotripsy twice. Once to break a 7mm stone and once to break a 5mm stone. The procedure itself gives very little pain at all, almost like getting pinged with an elastic band over and over. After about 20 pings though, the area goes numb and you pretty much feel nothing at all.

After the procedure you should feel no pain on the skin. Sometimes (this did not happen to me though) the Lithotripsy can bruise the kidney, which would give mild pain and discomfort (I have had a bruised kidney in the past after a bad fall, Paracetamol is all you would need for it).

You may however, experience some pain as the broken stone fragments come out in the urine, but I can't tell you how bad this is, as my Lithotripsy failed to break the stone both times. This is apparently very common.

Lithotripsy is commonly unsuccessful and to me pretty much a waste of time, but I wish you luck.

If yours has failed, you will then be given a procedure where a scope is passed up the urethra into the bladder to get to the stone. This can be pretty sore afterwards but with painkillers the pain is similar to a bad headache, and will pass in 24-48 hours.

Don't worry too much, the procedures involved in kidney stone removal are minimally invasive with very low risks and low pain.


What should I expect after surgery pain wise?

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