Medical & Surgical Urology
Open Access

Analysing the Effects of Lithotripsy on Kidney Function and Recovery

Suhan Roy^{* *}Correspondence: Suhan Roy, Department of Urology, Kyoto University, Kyoto, Japan, Email:

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Description

Lithotripsy is a non-invasive medical procedure designed to treat kidney stones, a common condition that affects millions of people worldwide. Characterized by the formation of hard mineral deposits in the kidneys, these stones can lead to severe pain, urinary obstruction, and complications if not effectively managed. Lithotripsy has revolutionized the approach to treating nephrolithiasis, offering patients a safe and effective means of stone removal.

Types of lithotripsy

There are primarily two types of lithotripsy: Extracorporeal Shock Wave Lithotripsy (ESWL) and ureterostomy with laser lithotripsy.

ESWL: It is the most widely used method. It utilizes shock waves generated outside the body to break kidney stones into smaller fragments, allowing for easier passage through the urinary tract. ESWL is particularly effective for stones that are less than 2 cm in size and located in the kidneys or upper ureter.

Ureterostomy with laser lithotripsy: It involves the use of a ureter scope, a thin tube that is inserted through the urethra and bladder into the ureter. Once the stone is located, a laser is used to break it into smaller pieces. This method is often preferred for larger stones or those located lower in the urinary tract.

Indications for lithotripsy

Lithotripsy is indicated in various scenarios, including:

Symptomatic kidney stones: Patients experiencing intense pain, haematuria (blood in urine), or urinary obstruction due to stones.

Stones unresponsive to conservative management: If hydration and medication fail to facilitate stone passage, lithotripsy may be necessary.

Recurrent stones: Individuals with a history of frequent stone formation may benefit from lithotripsy to prevent future complications.

Mechanism of action

The mechanism of lithotripsy is both simple and delicate In ESWL, the process begins with imaging techniques, such as ultrasound or fluoroscopy, to locate the stone's exact location. Once identified, shock waves are generated by a lithotripter a specialized machine that produces focused energy pulses. These shock waves create micro fractures in the stone, progressively breaking it down into smaller fragments that can be expelled naturally through urine.

In ureterostomy, the ureter scope allows for direct visualization of the stone. The laser energy is precisely targeted, enabling the physician to fragment the stone into dust or smaller pieces, facilitating their removal.

Lithotripsy procedure

The lithotripsy procedure typically involves several key steps:

Preoperative evaluation: A thorough medical history and physical examination are conducted. Imaging studies, such as computed tomography scans or ultrasounds, help determine the size, location, and composition of the stones.

Preparation: Patients are usually instructed to fast for several h before the procedure. Sedation or general anesthesia may be administered to ensure comfort.

Recovery from lithotripsy varies depending on the type of procedure performed.

After ESWL, patients may experience mild discomfort, haematuria, or the sensation of passing stone fragments. Most individuals can return to normal activities within a few days, although some may require pain management. Following ureterostomy, patients may have a urinary catheter temporarily placed to assist with urine drainage. Discomfort may be more pronounced, and individuals may experience urgency or frequency in urination. Full recovery usually takes about one to two weeks.

Patients are advised to increase fluid intake to help flush out stone fragments and reduce the risk of new stone formation.

Follow-up appointments are essential to monitor progress and ensure that stones have been adequately cleared.

Potential complications

While lithotripsy is generally safe, some complications may arise:

Infection: There is a risk of urinary tract infections following lithotripsy. Prophylactic antibiotics may be administered to minimize this risk.

Bleeding: Haematuria is common after the procedure, but excessive bleeding may necessitate further evaluation.

Incomplete stone fragmentation: Sometimes, stones may not be entirely broken down, requiring additional treatments.

Urinary tract injury: Rarely, the procedure can cause injury to the urinary tract, requiring surgical intervention.

Recurrence of stones: Lithotripsy does not prevent new stone formation. Patients need to adopt lifestyle changes and preventive measures to reduce this risk.

Conclusion

Lithotripsy has become a key role in the management of kidney stones, providing a non-invasive and effective alternative to traditional surgical methods. By understanding its mechanisms, procedures, and potential complications, patients can make informed decisions regarding their treatment options. With appropriate care and follow-up, lithotripsy can significantly alleviate the discomfort associated with nephrolithiasis and improve the quality of life for individuals affected by this condition. Ongoing advancements in technology and techniques are steadily improving the efficacy and safety of this essential urological procedure, Spreading hope for even better outcomes in the future.