Synonyms: Laparoscopic Stone Surgery, Extracorporeal Shock Wave Lithotripsy (ECSWL), Laser Lithotripsy, Percutaneous Lithotripsy, Endoscopic Lithotripsy, Intracorporeal Shock Wave Lithotripsy (ICSWL), Stone Removal, Stone Fragmenting, Calculus Removal, Endoscopic Stone Removal, Urinary Tract Endoscopy, Urologic Endoscopy
Lithotripsy is a non-invasive procedure that uses shock waves (thus the term Shock Wave Lithotripsy) to break up stones that form in the kidney, ureter and urinary bladder. The alternative names for Lithotripsy procedure are Extracorporeal Shock Wave Lithotripsy (ECSWL), Laser Lithotripsy, Percutaneous Lithotripsy, Endoscopic Lithotripsy or Intracorporeal Shock Wave Lithotripsy (ICSWL).
Where can I get Lithotripsy?
Cost of procedure performed in the US: $5,000 to $7,000.
All prices are in US dollars and include the cost of the procedure and minimum hospital stay. Estimates and minimum hospital stay will vary depending upon individual needs and requirements.
Lithotripsy is performed if the stone is big in size, has an unusual shape (stag-horn) or is stuck (impacted) in the ureter and cannot be passed out during urination following forced diuresis.
What is Extracorporeal Shock Wave Lithotripsy (ECSWL) vs. Intracorporeal Shock Wave Lithotripsy (ICSWL)?
Extracorporeal Shock Wave Lithotripsy (ECSWL) is a procedure in which shock waves are created outside the body that travel through the skin and body tissues until they hit the denser stones. The stones break down into sand-like particles and are easily passed through the urinary tract in the urine. Intracorporeal Shock Wave Lithotripsy (ICSWL) refers to the visualization of a calculus in the urinary tract during Cystoscopy / Ureteroscopy and the simultaneous application of ultrasound or laser waves to fragment the stone into small pieces like grains of sand that can either be extracted or passed in the urine.
If you have stone(s) in kidney, ureter or urinary bladder then you are an ideal candidate for Lithotripsy. In order to determine who is an ideal candidate for Lithotripsy, it is also important to keep in to consideration the size, location, shape and number of stones in the urinary organs.
You will be instructed not to eat or drink anything at least 12 hours before the Lithotripsy procedure. Wear comfortable clothing so that you can change easily into a surgical gown for the surgery. The entire Lithotripsy procedure may take approximately one hour. You will receive local anesthesia with sedation to minimize pain and discomfort however, at the same time you will be required to stay still during the Lithotripsy procedure. You might experience a mild tapping sensation during the procedure. There might be mild discomfort or pain during the procedure. There are two techniques available that are equally effective and widely used at most medical facilities. One method is that you will lay on a soft cushion through which the shock waves pass. About 2 - 8 thousand shock waves are needed to crush and fragment the stone(s) in a single Lithotripsy procedure. The second method is you will be asked to lay in a special tub filled with warm water, stones will be located and visualized by x-ray or ultrasound and shock waves will be directed from the Lithotripsy machine called Lithotripter. These shock waves will pass through your skin and are completely harmless. The procedure described above is that of Extracorporeal Shock Wave Lithotripsy (ECSWL). For Intracorporeal Shock Wave Lithotripsy (ICSWL), an endoscope or Cystoscope is used to get close to the stone inside the urinary tract and laser waves are applied to fragment the stone into small particles. Intracorporeal Shock Wave Lithotripsy (ICSWL) or Laser Lithotripsy is usually performed when the Extracorporeal Shock Wave Lithotripsy (ECSWL) technique fails. The sand like particles of the stone are either fished out in a basket attached to the Cystoscope and extracted out or they are passed out naturally during urination. Sometimes a stent is inserted in the ureter to keep it patent and facilitate the passage of stone fragments and debris with the urine, over the next few days. You will spend the next couple of hours in the recovery room under observation for bleeding or any other immediate complications. You will be allowed to go home after one or two days following the Lithotripsy procedure.
Before the Lithotripsy procedure, a complete physical examination and tests will be done to determine the number, location, and size of the stone(s). A test called an Intravenous Pyelogram (IVP), is used to locate the stone(s). An IVP is a procedure in which a radio-opaque dye is injected into a vein in the arm. This dye will show up on x-ray as it travels through the bloodstream and will be excreted by the kidneys. The dye will then flow down the ureter and into the urinary bladder. The radio-opaque dye surrounds the stones and will appear on the x rays as dark shadows or filling defects. Make sure that your physician rules out any allergies to the dye. Stop smoking and do not take aspirin to prevent bleeding problems to occur. Make sure that you are not pregnant or have heart disease before having Lithotripsy performed. Some patients may have a stent placed prior to the Lithotripsy procedure. A stent is a plastic tube placed in the ureter which allows the passage of gravel and urine after the Extracorporeal Shock Wave Lithotripsy (ECSWL) procedure is completed.
You will probably have a lot of blood in the urine after the Lithotripsy procedure. This is normal and should clear after several days or so. Lots of fluids should be taken to encourage the flushing of any gravel (forced diuresis) remaining in the urinary system. For the next couple of days after Lithotripsy, you will be instructed to collect your 24 hour urine and send it to the laboratory for analysis of the debris. You will be prescribed pain medication, antibiotics and anti-inflammatory medication to relieve pain, treat infection and subside inflammation. Drinking plenty of clear fluids (including water) will prevent the kidney stones from recurring. You should follow up with your urologist in about two weeks to make sure that everything is going well. If a stent has been inserted during Lithotripsy, it is normally removed at this time. In about a week you will feel better and can resume your normal activities.
Lithotripsy has a high success rate and approximately 90% of patients who undergo this treatment are completely symptom free within 3 months of treatment. If more stones are detected on follow up X-rays or ultrasound, then the procedure of Intracorporeal Shock Wave Lithotripsy (ICSWL) can easily and safely be repeated.
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Keywords: Kidney Stones, Bladder Stones, Cystitis, Urinary Tract Infection, Hematuria (Blood in urine), Urethral Stricture, Ureteroscope, Prostate Enlargement, Cystoscope, Intravenous Pyelography (IVP), Urinary Incontinence, Overactive Bladder, Urinalysis, Bladder Catheter, Painful Urination, Pelvic Pain, Iinterstitial Cystitis, Urinary Blockage, Narrowing of the Urinary Tract, Stone in the Urinary Tract, Bladder Cancer, Bladder Biopsy, Kidney Tumor, Non-invasive Treatment, Lithotripter, Urinary Tract Calculi, Ureteral Stones, Renal Stones