Lithotripsy

Welcome to:                             

The Lithotripsy Suite

The Richmond Urology Unit

Leigh Infirmary

The Avenue

Leigh

WN7 1HS

Telephone: 01942 264491 or 01942 264056

This leaflet aims to give you information about your procedure, time in hospital and advice for when you go home.

If there is anything you are worried about that is not covered by this leaflet, please feel free to speak to a member of staff.

For relatives who wish to wait there is a waiting area on the Richmond Urology Unit or the hospital dining room.

What is Lithotripsy?

Lithotripsy is a method of breaking up kidney/ureteric stones by sound waves, into small pieces so that they can be passed naturally via urine.

The Lithotriptor machine directs shock waves (sound waves) through the skin into the stones causing them to break up or crumble. The procedure usually takes approximately 30 minutes. In some patients more than one session is required depending upon size and consistency of stone.

Are there any risks involved in this procedure?

Common

• Bleeding on passing urine for short period after the procedure.
• Pain in the kidney after treatment as small fragments of stone pass. 
• Urinary tract infection from bacteria released from the stone when fragmented needing antibiotic treatment.
• Bruising or blistering of the skin in the loin or on the front of the abdomen.
• Need for repeated Extracorporeal shock wave lithotripsy treatments.
• Stone will not break as too hard requiring an alternative treatment.

Occasional

• Severe infection requiring hospitalisation, intravenous antibiotics and sometimes drainage of the kidney by a small drain placed through the back into the kidney.
• Stone fragments occasionally get stuck in the tube between the kidney and the bladder requiring hospital attendance and occasionally surgery to remove the stone fragments.

Rare

• Kidney damage (bruising) or infection needing further treatment.
• Recurrence of stones.

Benefits

• Non-invasive treatment to deal with appropriate stone. 
• It does not require a general anaesthetic.
• Treatment can be done as a day case procedure.
• Within a couple of days most people feel able to resume normal activities.

Alternative therapy

Telescopic surgery, open surgery, or observation.

Medication

 If you are on warfarin, clopidogrel or similar medication to thin your blood please make sure the surgeon knows when your procedure is booked. The surgeon will then advise you about taking these medications and if you will be required to stop taking them.

If you are taking tablets for high blood pressure or a heart complaint, take as usual.

Before admission

You may eat and drink as normal prior to admission.

We would strongly advise you to decide for a responsible adult to collect you and take you home, especially if it is your first time to attend for lithotripsy. Patients who require extra pain relief during the procedure will require a driver. You should not use public transport. We recommend that you go home, and rest and it is preferable that you decide for someone to stay with you but if this is not possible then arrange that you have someone you can contact. 

Please bring the following with you:

• A list of any medications you are taking.
• If you are diabetic have your normal breakfast and medication. Please bring your medication/insulin with you.
• Please do not bring valuables with you.

What will happen when I come into hospital?

On arrival to hospital, please report to The Richmond Urology Unit. You will be welcomed by the Receptionist who will introduce you to your nurse and other members of the team who will be looking after you.  The nurse will ask you some routine questions about your general health, medication, allergies etc.  Your Consultant/Dr will also see you and will ask you to sign a consent form. Prior to the procedure, you will need an x-ray.  You will receive an appointment from the Radiology Department for this to be done either the day before, or on the day of your procedure.

Please note that you will be on a lithotripsy list with several other patients, so please be prepared for a wait.

Lithotripsy procedure

When it is your turn for the procedure, you will be taken to the treatment area where your lithotripsy will be performed.  You will be asked to climb onto the table and lie either on your back or stomach.  Gel is applied to the area where the shock waves are being administered.  The lithotripsy machine is put in place over the intended area.  Ultrasound/x-ray equipment may be used to locate the stone.  It is very important that you try to remain still.  You will hear a clicking noise throughout the procedure as the shock waves are being administered.

Pain relief

Some patients will experience a degree of discomfort or pain during the procedure.  To keep you as comfortable as possible, you will be given strong pain killers before the procedure. 

What can you expect when you go home?

You may experience some pain after the procedure. This is due to the stones breaking and moving and the length of time it lasts will differ with each individual. You should have adequate pain relief at home.

You may also experience some localised redness where the shock waves were directed. This is not usually sore and will gradually reduce.

Fluid intake

It is important to drink plenty of fluids after treatment. Try to drink between two to three litres per day, as this will help the stones to pass.