Lithotripsy means the breaking up stones in the urinary tract into fine gravel or sand-like crystals, small enough to be passed out in your urine.
There are two methods used, shock waves or laser beams.
Extracorporeal shock wave lithotripsy (ESWL)
This uses high-energy shock waves to break down kidney stones and stones in the ureters without the need for anaesthesia, although you will usually be offered a sedative to relieve anxiety and help you relax, and an injection of painkiller.
The exact position of your kidney stone or stones is located by ultrasound, and then a lithotripter sensor sends shock waves through the skin of your back directly onto each stone. The intensity of the shock waves is gradually increased and the process takes about 30 to 60 minutes.
Extracorporeal shock wave lithotripsy is not entirely painless, and you are required to remain still throughout the procedure, but it avoids the added complications of general anaesthesia and invasive surgery, and you can go home the same day. Drinking at least 3 litres of fluids a day will help flush out the fragments. Depending on how many kidney stones you have, you may need to have more than one treatment.
If the stone is lodged in a ureter – one of the tubes that leads from a kidney to the bladder – a long, thin, flexible instrument called an ureteroscope will be directed up through your urinary tract to administer either laser beams or shock waves directly to the stone. This procedure, which should not take more than 30 minutes, is usually done under general anaesthetic, and the patient goes home the same day.
Using laser technology, fragmentation is very precise and inflicts minimal damage on the surrounding tissue. With this technique there are few complications, results are much better, and stone fragments can be removed after breakup via the ureteroscope.