Shock Wave Lithotripsy
Many years ago, urinary stones were treated almost always by surgery. The advent of new technology has made stone surgery virtually nonexistent today. Most stones are shattered by shock wave or laser energy. This energy can be delivered by endoscopes, laser fibers and catheters. Extracorporeal shock wave lithotripsy (ESWL) is the shattering of stones using shock waves delivered from outside the body.
The first shock wave lithotripter used a tub of water in which the patient was immersed. Shock waves delivered through this water bath focused on and shattered the patient’s urinary stone. This methodology was cumbersome and required general anesthesia. Technology has advanced to where shock wave lithotripsy machines no longer use a water bath but a generator that is applied to the back of the patient who is lying on a comfortable table. Shock wave lithotripsy is a faster method than surgery and results in less discomfort and a much quicker recovery.
What Are Kidney Stones?
Kidney stones are hardened salt and mineral deposits which form inside the kidney. When the urine is concentrated, chemicals can precipitate causing crystals to form ín the urine. These crystals can aggregate and grow and eventually become a stone. A stone causes a problem when it obstructs the flow of urine from the kidney.
The ureter is a small tube which carries urine from the kidney to the bladder. This small caliber tube can easily become obstructed by a stone (like a marble in a hose). When the kidney becomes obstructed, increased pressure occurs and severe pain results, shock wave lithotripsy can break stones in the kidney and in the ureter and is often the first line of therapy for painful kidney stones.
How Is Lithotripsy Performed?
When a patient scheduled for lithotripsy arrives at the Lithotripsy Center, he/she is greeted by the staff and anesthesiologist who will discuss the case and answer questions. He/She is then brought to the lithotripsy room where he/she is placed on the lithotripsy table. An intravenous infusion is started. Through this infusion, sedative drugs are given to make the patient comfortable and relaxed. The stone is then located by x-ray or ultrasound and then shock waves are delivered to the kidney stone through the patient’s back. These shock waves usually shatter the stone into small fragments. This treatment is very well tolerated and rarely requires more than heavy sedation.
After the stone has been shattered, the patient is brought to a recovery area where after a short stay he/she will, be discharged. Following the treatment, the patient will be seen in the office shortly for follow-up. The patient will be given a strainer to strain stone fragments as they pass out of the urinary tract so that they can be sent to the laboratory for analysis. One also may pass blood in the urine which is common and not dangerous. If the stone fragments do not pass and cause discomfort, further procedures are sometimes required.
Extracorporeal shock wave lithotripsy and other forms of lithotripsy are covered by all insurances including Medicare. If you have any questions about lithotripsy or stone disease, please do not hesitate to contact the office.