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A tube called a stent may be placed through your back or bladder into your kidney. This tube will drain urine from your kidney until all the small pieces of stone pass out of your body. This may be done before or after your lithotripsy treatment.
The introduction of lithotripsy in the early 1980s revolutionized the treatment of patients with kidney stone disease. Patients who once requiredmajor surgery to remove their stones could be treated with lithotripsy, andnot even require an incision. As such, lithotripsy is the only non-invasivetreatment for kidney stones, meaning no incision or internal telescopicdevice is required.
In the two-plus decades since lithotripsy was first performed in the United States, we have learned a great deal about how different patients respond to this technology. It turns out that we can identify some patients who will be unlikely to experience a successful outcome following lithotripsy, whereas we may predict that other patients will be more likely to clear their stones. Although many of these parameters are beyond anyone's control, such as the stone size and location in the kidney, there are other maneuvers that can be done during lithotripsy treatment that may positively influence the outcome of the procedure. At the Brady Urological Institute, our surgeons have researched techniques to make lithotripsy safer and more effective, and we incorporate our own findings as well as those of other leading groups to provide a truly state of the art treatment.
Patients with cardiac pacemakers should notify their doctor. Lithotripsy may be performed on patients with pacemakers with the approval of a cardiologist and using certain precautions. Rate-responsive pacemakers that are implanted in the abdomen may be damaged during lithotripsy.
Extracorporeal shock wave lithotripsy is a technique for treating stones in the kidney and ureter that does not require surgery. Instead, high energy shock waves are passed through the body and 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.
Also the stones must be clearly viewed by the x-ray monitor so the shock waves can be targeted accurately. If anatomical abnormalities prevent this, other methods of stone removal may have to be considered. Through examination, x-ray and other tests, the doctor can decide whether this is the best treatment for the patient. In some cases, extracorporeal shock wave lithotripsy may be combined with other forms of treatment.
Percutaneous Stone RemovalWhen stones are quite large (more than 2 cm) or in a location that does not allow effective lithotripsy, a technique called percutaneous stone removal may be used. In this method, the surgeon makes a small incision in the back and creates a tunnel directly into the kidney. A tube is inserted and the stone is removed through this tube.
The cost of lithotripsy varies. Check with your urologist or your local medical center for information about current costs. If you are considering this procedure, contact your insurance company to make sure that costs are covered.
Treatment is available at many hospitals, outpatient centers and sometimes even in mobile units. For information about where to have lithotripsy done in your area, contact your doctor, local hospital or health care facility.
If stones do not pass, they can damage the kidneys and urinary tract. When medications do not help, a lithotripsy procedure can break the stones down into smaller pieces so that they can come out in the urine.
The two main types of lithotripsy are extracorporeal shock wave lithotripsy (ESWL) and laser lithotripsy. Laser lithotripsy is sometimes known as flexible ureteroscopy and laser lithotripsy (FURSL) because doctors use a tool called a ureteroscope.
Overall, 70% to 90% of people who are good candidates for shock wave lithotripsy are stone-free (as seen on follow-up X-rays) three months after treatment. You hav