Lithotripsy is a procedure used to treat kidney stones that are too large to pass through the urinary tract. It works by sending focused ultrasound energy or shock waves directly to the stone. The shock waves break a large stone into smaller stones that will pass through the urinary system. Lithotripsy lets people with certain types of kidney stones avoid surgery. To find the stone, healthcare providers use fluoroscopy. This is a series of moving X-ray pictures. They may also use ultrasound to find the stone.
There are 2 types of shock wave technology. In the original method, the person is placed in a tub of water through which the shock waves are sent. This method is still in use. More recently, machines have been developed that send shock waves through padded cushions on a table.
When substances normally excreted through the kidneys stay in the kidney, they may crystallize and harden into a kidney stone. If the stones break free, they can get stuck in, the narrower passages of the urinary tract. Some kidney stones are small or smooth enough to pass easily through the urinary tract without discomfort. Other stones may have rough edges or grow as large as a pea. These can cause great pain as they move through or stick in the urinary tract. The areas that are more prone to trapping kidney stones are the bladder, ureters, and urethra.
Most kidney stones are small enough to pass without treatment. But, in about 20% of cases, the stone is greater than 2 cm (about 1 inch) and may need treatment. Most kidney stones are made of calcium. But, there are other types of kidney stones. Types of kidney stones include:
When kidney stones get too large to pass through the urinary tract, they may cause severe pain and may block the flow of urine. This can cause infection.
There may be other reasons for your healthcare provider to advise lithotripsy.
Risks of lithotripsy may include:
Not everyone is able to have lithotripsy including those with:
Tell your healthcare provider with you have a heart pacemaker. Lithotripsy may be done on people with pacemakers with the approval of a cardiologist and by using certain precautions. Be sure to discuss any concerns with your healthcare provider before the procedure.
You may want to ask your healthcare provider about the amount of radiation used during lithotripsy. It is a good idea to keep a record of your radiation exposure, such as previous scans and other types of X-rays, so that you can tell your healthcare provider. Radiation risks may be related to the cumulative exposure over time.
Lithotripsy may be done on an outpatient basis or as part of a hospital stay. Procedures may vary depending on your condition and your healthcare provider’s practices.
Generally, lithotripsy follows this process:
Talk with your healthcare provider about what you will experience during your lithotripsy procedure.
After lithotripsy you will be taken to the recovery room for observation. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room or discharged home. Plan to have someone give you a ride home. You should not drive for at least 24 hours after getting sedatives for the procedure.
You may go back to your usual diet and activities unless your healthcare provider tells you otherwise.
You will be encouraged to drink extra fluids to dilute the urine and reduce the discomfort of passing stone pieces.
You may notice blood in your urine for a few days or longer after the procedure. This is normal.
You may notice bruising on the back or belly. This is also normal.
Take a pain reliever for soreness as recommended by your healthcare provider. Avoid aspirin or certain other pain medicines. They may increase the chance of bleeding. Be sure to take only recommended medicines.
You may be given antibiotics after the procedure. Be sure to take the medicine exactly as prescribed.
You may be asked to strain your urine so that remaining stones or stone pieces can be sent to the lab for testing.
A follow-up appointment will be scheduled within a few weeks after the procedure. If a stent was placed, it may be removed at this time.
Tell your healthcare provider to report any of the following:
Your healthcare team may give you other instructions after the procedure, depending on your particular situation.
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