Lithotripsy is a technique used to break up stones that form in the kidney, bladder, ureters, or gallbladder. There are several ways of doing this, although the most common is extracorporeal (outside the body) shock wave lithotripsy. The shock waves are focused on the kidney stone and break the stone into tiny pieces, which are passed out of the body naturally during urination. Throughout the procedure, the doctor can view what is happening to the stones through X-ray or ultrasound monitoring. This procedure prevents you from having to undergo surgery to have the stones removed, which reduces discomfort, complications, hospital stay, cost, and recovery time. You will usually be asked not to drink or eat anything for 6 hours prior to the procedure, or after midnight of the previous night, if the procedure is in the morning. If you take medicines, you should ask your doctor if they are safe to take before the procedure. For instance, you may be asked to stop taking aspirin and other drugs that interfere with blood clotting several days before. On the day of the procedure, you should wear comfortable clothes that are easy to remove, as you will have to change into a surgical gown. The procedure generally takes from 45 minutes to 1 hour. In most cases, you will be asked to lie on a table on top of a soft cushion, through which the shock waves are directed from the lithotripsy machine, called the lithotripter. Older machines require that you immerse yourself in a specially designed tub filled with water, and although less commonly used, these machines are still available today and are effective. Typically, you will receive some form of anesthesia, and depending on your level of sedation, you may feel a tapping sensation when the procedure begins. Since lithotripsy can cause mild discomfort, a mild sedative or painkiller is given beforehand. You should tell your doctor if you are pregnant, because lithotripsy must not be performed during pregnancy. While most kidney stones are treated with this type of lithotripsy, not all stones can be treated this way. Sometimes a laser is used to pulverize the stone, but when a laser is used, the doctor must use an endoscope, which is a tube introduced into the body, via the urinary tract, to get close to the stone. The doctor may also access the stone from your back into your kidney, through a procedure called percutaneous lithotripsy. Laser lithotripsy is usually used when the stone does not respond to extracorporeal shock wave treatment or when it is in a place that is difficult to access. It requires a hospital stay and carries a slightly greater risk of complications than extracorporeal shock wave lithotripsy.
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