Lithotripsy For Removal Of Kidney Stones

WHAT YOU SHOULD KNOW:

• Lithotripsy (LITH-oh-trip-see) is a procedure to remove kidney stones that are too large to pass on their own or are causing pain. It is also called extracorporeal (ek-strah-kor-POHR-ee-al) shock wave lithotripsy or "ESWL". Lithotripsy may also be done if the stone stops your kidney from working or blocks the flow of urine to your bladder. High energy shock waves are used to break the stones into tiny sand-like pieces. Then the broken up pieces can be passed (come out) in your urine. Lithotripsy usually takes one to two hours. You are usually able to go home the same day.
  
  
• Kidney stones are also called renal calculi. Kidney stones are rock-like pieces that can form anywhere in the urinary system. This includes the kidneys, bladder, ureters and urethra (urine tubes). They form most often in the kidneys, which are located one on each side in the back of your abdominal (center) area. Your kidneys clean waste from the blood and make urine. The stone may be large or small, and you may have more than one stone.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

You may have blood in your urine for one to two days after having a lithotripsy. Bruising and some minor pain in your back or abdominal area are also common. You may need another lithotripsy if the stone was not broken small enough to pass in your urine. You may also need other procedures to break up or remove your stone. Kidney stones can cause a kidney infection and can stop urine from moving out of your kidney. If a kidney stone is not treated, your kidneys could stop working and you may die. Call your caregiver if you are worried or have questions about your medicine or care.

WHILE YOU ARE HERE:

Before Your Lithotripsy:

• Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
  
  
• An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• KUB x-ray: You may need a KUB x-ray before surgery. An x-ray machine is used to take pictures of your kidneys (K), ureters (U), and bladder (B). Your caregivers look at these pictures to see where the kidney stone is located before the procedure.
  
  
• Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
  
  
• Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.
  
  
• Pre-Op care: You will be asked to change into a hospital gown. You may be given medicine in your IV to help you relax. A stent (tube) may be put into your ureter. This tube may make it easier for broken pieces of kidney stone to pass from your body. You may sit in a bath of warm water or lie on a water-filled cushion.
  
  
• Anesthesia: This medicine is given to make you comfortable. You may not feel discomfort, pressure, or pain. An adult will need to drive you home and should stay with you for 24 hours. Ask your caregiver if you can drive or use machinery within 24 hours. Also ask if and when you can drink alcohol or use over-the-counter medicine. You may not want to make important decisions until 24 hours have passed.
  
  
  • Local anesthesia: Medicine is used to numb the area of your body where the surgery or procedure will be done. It is usually injected into the skin. It also may be given as a gel or jelly applied to your gums for dental procedures or as a patch. For such areas as the genitals, medicine may be given as a cream on the skin or mucus membranes.
    
    
  • General anesthesia: Caregivers use this medicine to keep you asleep and free from pain during surgery. They give you anesthesia through your IV or as a gas. You may breathe in the gas through a mask or through a breathing tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

During Your Lithotripsy:

High energy shock waves are aimed at your kidney stone. When the waves hit the stone, they break it up into tiny sand-like pieces. These shock waves should not hurt your bones or tissues. X-rays or ultrasound are used to find the kidney stones and to watch them as they are broken. The broken pieces of stone pass down your ureters and into the bladder after a few days.

After Your Lithotripsy:

You will be taken to a recovery room. You will be there until you wake up and caregivers know that you are OK. You may be able to go home, or you will be taken to your hospital room. Do not get out of bed until your caregiver says it is OK.