Lithotripsy: Treatment, Procedure, Cost and Side Effects

Lithotripsy is a medical routine in which shock waves are used to break the kidney stones, gall bladder stones or the stones that are formed in the ureter. Lithotripsy makes sure that the hardened masses in the different organs are reduced to tiny pieces that can be easily carried by urine outside the body.

Many people develop stones in their kidneys, gall bladders and ureters. If these stones are small enough, they either get carried by urine outside the body or are cured by oral medications. However, if the stones become too big (between 4mm and 2cm in diameter), they may cause severe pain and block urine flow. Also, stones can cause kidney damage, infection in the urinary tract and fever. No medicine can cure the masses of these sizes formed in the organs. In such cases, lithotripsy is performed. Lithotripsy is a great way of removing stones from the body without operating on the patient. The procedure has mostly positive results in people having stones in their kidneys, ureters or gall bladders.

Lithotripsy can be performed in two ways- Extracorporeal Shock Wave Lithotripsy (ESWL) and Intracorporeal Lithotripsy or Endoscopic Lithotripsy.

Extracorporeal Shock Wave Lithotripsy (ESWL) : In this process, the patient is first placed on a water-filled cushion. Then X-rays are used to detect the exact location of the stones. In some cases, an ultrasound test may also be performed to to know the correct location. High-energy shock waves are then passed through the body to break down the stones into fine particles that can pass out of the body with urine. The stones are targeted by almost 1000 to 2000 shock waves for almost an hour. After this, sometimes, the doctor places a tube through the patient's bladder or back into the kidney to drain urine carrying all the particles of the stones.

Intracorporeal Lithotripsy: This type of lithotripsy is performed in patients in whom the exact location of the stones cannot be detected. This process is performed by inserting a tube with a camera and light tied to its tip into the urethra and then gradually upwards to the point where the stones are located. Then shock waves are passed to break down the stones. Intracorporeal lithotripsy is again of four types depending on the type and source of the shock waves - laser lithotripsy, mechanical lithotripsy, electrohydraulic lithotripsy and ultrasonic lithotripsy.

Kidney stones are very common and so are stones in gall bladders or ureters. Not all stones are of the same size. The stones that have diameters ranging between 4mm and 2 cmm can be treated by lithotripsy.

Lithotripsy is not an option for anyone who is pregnant because the X-rays and sound waves may harm the fetus. The procedure is also not suitable for people with bleeding disorders or those who are suffering from infection of kidney or urinary tract. The structure of the kidney must also be perfectly normal to be eligible for lithotripsy.

Lithotripsy breaks down the stones in the organs into little particles so that they pass out of the body with urine. The little particles can cause great pain when passing with the urine. The fragments can also get deposited in the urinary tract sometimes thus blocking the urine flow. In such cases, a ureteroscopy has to be performed to remove the fragments from the tract. It can also lead to infection of the urinary tract and bleeding outside the kidney.

Patients are advised to be at complete rest for at least 2 days. They also have to carry a urine strainer that catches the stone fragments passing with urine.

Lithotripsy is performed as an outpatient procedure. The patient has to be recovery for 2 hours after the procedure and then he can leave. The patient needs a resting period of 2 days to get on his feet. However, the leftover fragments of the stones may keep coming out of the body even a few weeks after the procedure. But that does not hinder any normal life function.

The cost of the lithotripsy procedure varies depending on its type. An EWSL can cost from Rs.20,000 to Rs.35,000 while a laser lithotripsy cost ranges between Rs.50,000 and Rs.80,000