Q1. What is Lithotripsy?
The process involves breaking up the stones present in the organs into smaller fragments using suitable techniques. Once broken up, these stones can be passed out of the body through urine.
Q2. What are the types of Lithotripsy surgery?
The three main kinds of lithotripsy procedures are:
- Extracorporeal Shock Wave Lithotripsy (ESWL): ESWL is a non-invasive procedure, i.e., the process is performed from outside the body. The procedure involves high intensity acoustic pulses applied externally in an attempt to break up the stone with minimum collateral damage. The high energy shock waves are passed through the body until they hit the stone in the body and break it up into finer fragments. This procedure is generally used for soft stones preferably smaller than 2cm diameter. It is advisable to use ESWL for patients of diabetes and hypertension and the patients having a solitary kidney.
- Laser Lithotripsy: This Lithotripsy procedure is carried out by surgical means. A thin scope is inserted into the urinary tract of the patient to observe the position of the stone. Once the stone is located, a laser fibre is passed through the working shaft of the scope and high intensity laser beams are emitted directly to the stone to disintegrate it. Larger and harder stones can be disintegrated using laser lithotripsy. It is generally advisable to go for laser lithotripsy for kidney stones.
- Holmium Laser Lithotripsy: Holmium Laser Lithotripsy is an improved laser lithotripsy procedure. During this process holmium laser, emitting infra red beams (2100nm wavelength), is used to disintegrate the stones. This process is specially used for stones, which are large in size or have a high concentration.
Q3. What are the other options for removal of kidney stone?
There are several kinds of kidney stones for which lithotripsy treatments may not be ideal. For such cases the following procedures are used:
- Endoscopy: This treatment involves insertion of a tube directly into the kidney to flush out the stone. A lighted, thin tube inserted into the ureters, which connect the kidneys to the bladder. The stone is passed from the kidney using specialized techniques and removed from the ureters using the lighted tube.
- Open surgery: This procedure is required in very rare cases when all the other treatments cannot be performed.
Q4. What are the indications for Lithotripsy?
The indications for lithotripsy include:
- Excessive pain in the organs
- Damage to the organ and loss of function of the organ where the stone is present
- Infections arising in the urinary tract of the body
- Internal bleeding in the organs
- The stone blocking regular flow of urine
Q5. Is lithotripsy painful?
The lithotripsy process is completely pain free, with the patients not feeling anything more than a slight tapping sensation during the process.
Q6. What all tests are to be done before & after Lithotripsy?
The tests to be carried out before the lithotripsy treatment include:
- A complete physical examination, carried out to determine the size, location and number of stones present in the body
- A pregnancy test is done for women of child bearing age to make sure that the woman is not pregnant as the shockwaves and lasers can harm the baby.
- For patients of elderly age, an EKG test is performed to ensure that the patient does not suffer from any potential heart disease.
- Tests for allergic reactions are carried out to ensure that the patient is not allergic to any of the components of the medications and fluids used in the lithotripsy treatment.
After the lithotripsy procedure, a few tests are performed to determine the success of the procedure. Patients are generally discharged on the same day of the treatment and tests are carried out after a few days to make sure that none of the stone particles are left in the organ.
Q7. What are the complications of lithotripsy?
Patients may witness some lithotripsy side effects after the procedure. These include:
- Small pieces of stones lodged into the ureters, blocking the flow of urine from the kidneys to the bladder
- Abnormality developing in the kidney function after lithotripsy
- Bleeding around the organ after the procedure. Blood transfusion may be needed to treat this complication
Q8. Who performs Lithotripsy?
Lithotripsy is generally performed by a trained technician with a physician, or urologist, supervising the process.
Q9. How long does the surgery take place?
Patients have to be admitted to the hospital for this procedure. A standard lithotripsy procedure is completed within 45 minutes to an hour.
Q10. How many days admission is required?
Generally, one can be admitted to the hospital on the day of treatment and can even be discharged on the same day.
Q11. How much time will it take to recover?
The recovery time after this procedure ranges between a few days to several weeks depending on the condition of the patient before the procedure and the effects that the stone had on the organ. If there are no complications following the procedure, the patient can recover completely in a week’s time.
Q12. What is the diet one should prefer?
The intake of water should be increased considerably in the days after the lithotripsy. The patients are advised to limit the intake of foods with high protein content and salt. Meats, bananas, pulses, nuts, coffee and green leafy vegetables should be avoided during the recovery period.
Q13. What is the total estimated cost?
The lithotripsy cost varies with the type of lithotripsy procedure performed for the patient. The general cost of ESWL process ranges between Rs. 15000 to Rs. 35000. The cost for laser lithotripsy and holmium laser lithotripsy is higher than ESWL. Lithotripsy cost for laser and holmium laser procedures may vary from Rs. 50000 to Rs. 80000.