Extracorporeal shockwave disintegration of stones

What is this?

This involves the administration of shockwaves through the skin to fragment urinary tract stones into small enough fragments to pass naturally. The procedure involves either x-ray or ultrasound scanning to localise the stone(s)

What alternatives are there?

Telescopic surgery, open surgery, observation to allow spontaneous passage

What to expect before procedure

You will usually be admitted on the same day as your treatment. It may be useful to bring your own dressing gown to wear over your hospital gown. You will first be asked to undergo swabbing of your nose & throat to ensure that you are not carrying MRSA. On arrival, an X-ray may be taken to confirm the presence of your stone(s). You may have a light meal on the morning of your treatment but you should drink only clear fluid in the 2-4 hours before the treatment. We will give you an injection of a strong pain-killer and an anti-inflammatory suppository once you arrive in the clinic.

What happens during the procedure?

Normally, no anaesthetic is necessary and you will be awake throughout the procedure. Treatment is normally carried out under sedation but children usually require a general anaesthetic. The treatment will be monitored by a nurse and a lithotripsy technician. The shock waves can cause deep discomfort in the kidney and a sensation of being flicked with an elastic band on the skin of your back. If this proves excessively painful, additional painkiller and sedation can be administered during the treatment. Treatment normally lasts between 30 and 60 minutes, depending on the size of your stone(s).

After the procedure

Immediately after the treatment, you may feel quite drowsy. You will normally be taken back to a cubicle to recover with a cup of tea or coffee. The Specialist Nurse will also perform routine post-operative checks. As soon as you have recovered from the treatment, you will be able to go home but you must bring someone with you to escort you home; you should not attempt to drive yourself because of the effects of the sedation. Antibiotics and painkillers will be given to you before your discharge. The average hospital stay is less than 1 day.

Potential side effects