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Lithotripsy for Large Kidney Stones: What to Expect

Lithotripsy for Large Kidney Stones: What to Expect

Kidney stones are hard mineral deposits that develop for different reasons, including eating too much protein, not drinking enough water, or genetic causes. These little stones can trigger big pain, bringing over half a million adults in the United States to the ER every year. 

When your urinary system doesn’t have sufficient amounts of water, crystal-forming minerals, like calcium, salt, oxalate, and uric acid, form hard deposits, or stones. These crystallized mineral deposits vary in size, from as small as a grain of sand to about the size of a ping-pong ball.

All kidney stones can cause pain or discomfort, but larger stones typically cause worsening symptoms, which can include:

Smaller kidney stones can usually pass on their own. But larger kidney stones may require medical intervention to help move them through your kidney and out of your system. 

The board-certified providers at Urological Associates in Charlottesville, Virginia, use an innovative therapy called lithotripsy to break down larger kidney stones into smaller pieces, making it easier for your body to pass them.

Here’s a closer look at lithotripsy and what you can expect after this medical treatment.

About lithotripsy and what to expect

When your kidney stone is too large to pass through your urinary tract, your provider may recommend non-invasive lithotripsy. The treatment uses energy waves directed at the stone to break it into pieces small enough to pass through your system. 

Before starting your treatment, your Urological Associates provider locates the stone using a special X-ray (fluoroscopy) or ultrasound. They then send the energy waves directly to the stone, breaking it up and helping prevent more invasive therapies, like surgery. 

There are different types of lithotripsy, and the right one depends on multiple factors, including the size of your stones. Your provider recommends which is best for your situation. Here’s a look at the three types of lithotripsy:

Ultrasonic lithotripsy

Ultrasonic lithotripsy uses a probe to send high-frequency sound (ultrasonic) waves to the kidney stone. These ultrasonic waves break up the stone while the surrounding tissues and organs remain unharmed.

This outpatient procedure usually involves a mild anesthetic and typically lasts about an hour. After your treatment, you’ll be moved to recovery for observation. You can resume your normal activities once you’re cleared to return home. 

Electrohydraulic lithotripsy (EHL)

Electrohydraulic lithotripsy uses electrical shock waves to pulverize larger kidney stones. EHL requires general anesthesia, and you’ll need to fast before the treatment. Your provider uses an endoscope that’s inserted into your GI tract with a probe that delivers the energy.

The entire EHL procedure takes about 30-60 minutes, and you’ll need to stay at the clinic until you recover from the anesthesia. You should plan on resting for a few days after the therapy before returning to normal activities. 

Extracorporeal shock wave lithotripsy (ESWL)

ESWL uses thousands of pressure waves to break up certain types of larger kidney stones. This therapy replaces the major surgery that was once required for big kidney stones, and is the preferred treatment most of the time. 

This outpatient procedure usually involves sedation or light anesthesia, and the procedure lasts about an hour. After spending some time in recovery, you’ll return home the same day.

For all types of lithotripsy, you could need additional treatment sessions if you have an especially large kidney stone. 

What happens after lithotripsy

After all types of lithotripsy, you should drink extra water and fluids to help keep your urine diluted and make passing the stone pieces less painful. It generally takes anywhere from a few days to several weeks to pass the stones after treatment.

Having some blood in your urine is normal. You might also notice some bruising on your back, sides, or abdomen. 

To help with any discomfort from these bruises or from passing the stones, your Urology Associates provider may recommend a pain medication. Just be sure not to take other pain-alleviating medications that aren’t on the approved list, as they may increase bleeding. 

You’ll also need to take antibiotics after your treatment to prevent infection. Be sure to take all the medication as prescribed and don’t stop taking the antibiotics before the course is complete. 

If your provider asks you to strain your urine to collect stone particles for examination, be sure to follow their directions.

You can expect a follow-up appointment within a few weeks of your lithotripsy treatment. If you have any of the following urgent symptoms before that appointment, call your Urology Associates provider right away:

Learn more about lithotripsy by scheduling an appointment at Urological Associates in Charlottesville, Virginia.

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