EXTRA CORPOREAL SHOCK WAVE LITHOTRIPSY
What is extra corporeal shock wave lithotripsy?
corporeal shock wave lithotripsy is a technique for treating
stones in the kidney and ureter (without surgery).
High-energy shock waves are used to break stones into pieces
as small as grains of sand. Because of their small size,
these pieces can pass from the body along with the urine.
What does the treatment involve?
x-rays or ultrasound to pinpoint the location of the stones,
the body is positioned so that the stones are targeted
precisely. About 2500 pulses are usually needed to crush the
stones. The complete treatment takes about 45 to 60 minutes.
What are the advantages and disadvantages of this treatment?
main advantage of this treatment is that many patients may
be treated for kidney stones without surgery. As a result,
complications, hospital stays, costs and recovery time are
reduced. Unfortunately, not all types of kidney stones can
be treated this way. In addition, stone fragments are
occasionally left in the body and additional, treatments are
the patient need anesthesia?
some type of sedation is used to help the patient remain
still and to reduce any discomfort. Anaesthesia may be necessary
in young persons and for persons who are very sensitive
to pains. Usually, the patient will be asked not to drink
or eat anything for 6 hours prior to the procedure, or after
midnight of the previous night, if the procedure is in the
morning. If he take regular medicines, he should ask his
consultant if they are safe to take before the procedure.
For instance, the patient may be asked to stop taking ASPIRIN
and similar other drugs that interfere with blood clotting
several days before the treatment.
The patient should tell her consultant if she is pregnant,
because lithotripsy must not be performed during pregnancy.
the patient need to be hospitalized?
may be done on an outpatient basis. In some cases patients
are hospitalized for a day.
stones can cause a blockage in the ureter if the fragments
jam the ureter after being broken. To avoid this a tube
known as a JJ or Double J stent can be used at the discretion
of the Urologist.
J Stent :
J stents are small tubes, which pass from the kidney to
are called JJ stents because the top and bottom have a curled
end to prevent migration of the stent.
times stents irritate the bladder and make the patient feel
as if there is need to pass urine more often. This sensation
usually pass off after a few days.
stent also stop the normal one-way valve at the base of
the bladder, urine therefore can pass up to the kidney when
the patient passes urine, and this is felt as an ache during
end of passing urine an odd sensation is usually felt in
the lower abdomen.
Stents are removed under local anesthetic with a small cystoscope.
The procedure is not painful.
can form on the end of stents if they are left in the body
too long. The patient should make sure that their stent
is removed in time.
can the patient expect after treatment?
treatment is complete, the patient can move about almost
immediately. Many people can fully resume daily activities
within a day. Special diets are not required, but drinking
plenty of water helps the stone fragments pass. Some pain
may occur when the fragments pass, which begins soon after
treatment and may last for up to one to two weeks. Oral
pain medications and drinking lots of water will help relieve
are the complications or side effects?
patients have some blood in the urine for a few days. The
shattered stone fragments may cause discomfort as they pass
through the urinary tract.
all kidney stone patients have this kind of treatment?
The size, number and location of the stones are factors
that must be taken into account when exploring treatment
options. The doctor can decide whether this is the best
treatment for the patient. In some cases, extra corporeal
shock wave lithotripsy may be combined with other forms
successful is this type of treatment?
patients who are thought to be good candidates for this
treatment, about 80 to 90 percent are found to be free of
stones within three months of treatment. The highest success
rates seem to be in those patients with mobile stones that
are located in the upper portions of the urinary tract (kidney
and upper ureter). After treatment, some patients may still
have stone fragments that are too large to be passed. These
can be treated again if symptoms persist.