Kidney Stone Removal (Lithotripsy) in the Chicago Region

Lithotripsy is the most common treatment for kidney stones. In the procedure, shock waves directed from outside your body are aimed at the stones. The shock waves break up the stones into small pieces that can exit your body through your urine.

The procedure is used when kidney stones — often made of calcium or uric acid — are too large (usually 5 millimeters or larger) to exit your body through your urinary tract. The procedure is also used when large stones may be blocking your urine flow, or are causing bleeding or kidney infection. The procedure is also used if the kidney stones are causing pain that can't be helped by pain relievers.

Your doctor likely will ask you to stop taking blood thinners like aspirin and ibuprofen in the days before the procedure. Those drugs decrease your blood's ability to clot.

You also may be instructed not to eat or drink anything in the several hours before the procedure.

You will put on a hospital gown and lie on an exam table. A water-filled cushion will be positioned underneath you, near the area to be treated. The medical providers performing the test will position your body so they can easily target the stones with the shock waves.

You will be given medicine to help you relax and will be given local or regional anesthesia in the area of your body where the procedure will take place. In some situations, you may be given general anesthesia, which means you will be asleep during the procedure. You'll also be given antibiotics to prevent infection.

Your health care providers will use x-rays and ultrasound to determine where the kidney stones are located. They will then direct the high-energy sound waves, also called shock waves, at the kidney stones from outside your body. If you've been given local anesthesia, you may notice a tapping feeling but will feel no pain. The treatment usually takes 45 minutes to an hour.

In most cases, patients will go home the day of the procedure. You likely will stay in the medical facility's recovery room for an hour or two afterwards.

Most people can resume normal activities a day or two after the procedure.

Your doctor may give you a urine strainer to catch the tiny bits of stone that will likely pass in your urine in the days or weeks afterwards. Those stones can be tested to better understand your condition.

In the several days after the procedure, you may notice side effects like blood in your urine and some pain. Taking over-the-counter pain medication and drinking plenty of fluids will help the pain.

The primary advantage of lithotripsy is that it doesn't require an incision or more complicated surgery to remove the stones. Those alternative kidney stone treatments mean longer recovery times, longer hospital stays and higher risks of complications.

About 70 to 80 percent of patients who are appropriate candidates for the surgery will be free of kidney stones three months after the procedure. The highest success rates are among patients with the smallest kidney stones. In general, people with stones that are less than 1.5 centimeters in diameter are the best candidates for the procedure.

No. Some people who have the procedure may still have the kidney stones afterwards. Most often, those are people who have larger stones. Also, some patients are not good candidates for this procedure. They include:

• pregnant women, because the shock waves could harm the fetus
• people with bleeding disorders
• people with infections
• people with skeletal abnormalities
• people who are very obese

For cases where the stones can't be broken apart by lithotripsy, other procedures might help. They include:

• A procedure in which a doctor makes a small incision and inserts a small tube called an endoscope into the kidney.
• A procedure in which a doctor inserts a small lighted tube called a ureteroscope into the bladder and ureter, then uses a device inserted into the tube to grab the stone and remove it.
• A procedure in which a doctor uses a special scope to insert a stent into the urinary track to help the stones pass through the tract more easily.
• Open surgery (rarely)