Extracorporeal shock wave lithotripsy.
The extracorporeal shock wave lithotripsy technique uses shock waves from the lithotripter, which are transmitted in focus to the stones through the skin in contact with the machine, to shatter the stones. The shattered stones can be excreted naturally from the urine. Since the lithotripsy is performed outside the body using the machine, there is no wound (individual skin breakage). This treatment requires no anesthesia and no hospitalization.
Indications:
Kidney stones / ureteral stones (including pelvic segment ureteral stones) bladder stones, size: less than 2.2 cm
1. All urinary stones ≤ 2.2 cm are indications for extracorporeal shock wave and are preferred internationally for extracorporeal shock wave treatment. For a few stones, extracorporeal lithotripsy may not be suitable for all patients because of their size, location, kidney function, and whether the urinary system is severely obstructed, etc. Please consult your doctor for details.
2. If you have other medical conditions such as bleeding tendency, serious heart disease, or are taking other medications such as anticoagulants (aspirin, warfarin, etc.), the risk of extracorporeal lithotripsy is greatly increased and a detailed assessment of whether to proceed with this treatment and how to minimize the risk should be made by your doctor. Please consult your physician for more information.
3. If there is significant hematuria and urinary leukocytes of 2+ and above, antibiotics will be administered prophylactically and extracorporeal shock wave therapy cannot be performed immediately if fever is present.
Contraindications.
1.Urinary obstruction below the stone or the presence of significant ureteral stenosis, lithotripsy may not be discharged; 2.Uncorrectable bleeding disorders; 3.Uncontrolled urinary tract infection; 4.Pregnant women, severe obesity, skeletal deformities and other special patients; 5.Isolated kidney or transplanted kidney combined with severe renal insufficiency; 6.Some high-risk patients such as heart failure, severe arrhythmia, systemic active tuberculosis etc..
Preparation.
1, stop taking certain drugs such as aspirin and other anticoagulant drugs as prescribed by the doctor.
2.Treatment patients can eat at breakfast, but not too full, do not eat some easy gas-producing foods, such as milk, soy and eggs, etc. Do not eat foods that affect X-ray fluoroscopy, such as bones, etc.
3. Come to the lithotripsy center on time on the day of treatment.
4.After explanation by the doctor, you need to sign the treatment consent form.
Treatment procedure.
You will be placed in a supine or prone position on the treatment bed. The location of the stone will be determined by X-ray or ultrasound, and the stone will be broken up by shock waves from the lithotripsy machine, which emits a rhythmic sound during the process. The whole procedure takes about 40 minutes. During the treatment, you may feel some pain, so please cooperate and do not move your body. If necessary, the doctor will give painkillers to reduce the pain.
Treatment results.
The key to successful extracorporeal shock wave is accurate stone localization by the doctor, real-time monitoring of lithotripsy and timely adjustment of stone positioning. The vast majority of stones in extracorporeal shock wave lithotripsy are usually successfully broken after one or more extracorporeal lithotripsy treatments. However, extracorporeal lithotripsy does not guarantee that all stones will be broken (e.g., larger or harder stones, especially in obese patients), nor does it guarantee that all stones broken will be removed (there is a risk of blockage in the ureter to form stone streets). If the treatment is successful, the stone will be expelled automatically in the next few days to weeks.
Tips.
1. Follow your doctor’s instructions if you need to take medication.
2. Drink plenty of boiled water (about 3000-4000ml per day) so that the urine output reaches 2000-3000ml per day and do more exercises (jumping rope, running, etc.) to facilitate the discharge of small stones.
3. During natural stone discharge, there will be pain and hematuria, occasionally causing renal colic, usually the pain is relieved by analgesic treatment, if the pain is not relieved, you can go to the emergency room of our hospital.
4. After treatment, urine can be filtered with gauze in order to observe whether stone powder is discharged and how it is discharged.
5. It is very important to come to the follow-up clinic on time (usually one week after lithotripsy) as instructed by the doctor, because after lithotripsy, it is necessary to closely observe whether the stone powder is discharged and whether the ureter is blocked, so that problems can be detected and treated at an early stage.
Possible complications.
1. Slight pain in the lower back and between the small of the abdomen, which disappears after several days.
2. Blood in the urine and pain, which need not be treated and will disappear after one or two days.
3. Bruising will appear on the epidermis of the treated area, this symptom will subside after one to two weeks.
4. Urinary tract infection.
5. Blockage of the ureter due to lithotripsy.
6. Less common complications include renal hematoma.
7. Other internal organ damage (rare). If patients experience any serious discomfort please go to our emergency room!
Postoperatively, when complications arise, the surgeon will promptly manage them, possibly by placing a catheter, ureteral stent or nephrostomy, and if necessary, by ureteroscopy or percutaneous nephrostomy or other related surgical treatment.