Electrohydraulic Lithotripsy Overview

Electrohydraulic lithotripsy is one of many types of techniques used to break kidney stones or bile stones. The electrohydraulic device uses a flexible probe to deliver electricity.

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Prior to Procedure

Your doctor may do the following:

• Physical exam

• Blood and urine tests

• Abdominal x-ray —a test that uses radiation to take a picture of structures inside the abdomen

• Intravenous pyelogram —an x-ray of the urinary system taken after the injection of contrast dye

• Spiral CT scan —a type of x-ray that uses a computer to make pictures of structures inside the body

• MRI scan —a test that uses magnetic waves to make pictures of structures inside the body

Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:

• Aspirin or other anti-inflammatory drugs

• Blood thinners (eg, warfarin , clopidogrel )

Anesthesia

General anesthesia is used. You will be asleep during the procedure. You will not feel any pain.

Description of the Procedure

Your doctor will place a tiny flexible probe through your urethra and up the ureter toward the stone. The probe has two electrodes at the end. Imaging guidance, like ultrasound, will help the doctor locate the stone. Once the stone is located, the doctor will activate the device. An electrical spark will break the stone. A special basket or forceps may be used to grab the stone fragments and remove them. The stone fragments may be allowed to pass in the urine.

Depending on the size of the stone, more than one probe may be used. A stent may be placed in the ureter. This will help protect the lining while the fragments pass or damage is being repaired.

There may be fragments that are too large to pass after the procedure. These can be treated again with lithotripsy.

How Long Will It Take?

30-60 minutes depending on size and location of the stone

How Much Will It Hurt?

Anesthesia prevents pain during the procedure. There may be some pain and discomfort afterward from the passage of broken stones. This can be managed with medicine.

Average Hospital Stay

This procedure is usually done in an outpatient setting. In most cases, there will be no hospital stay.

Post-procedure Care

At the Hospital

• You will be monitored as you recover from anesthesia.

• Pain medicine will be given.

• You may be asked to get up and walk around before leaving the hospital.

At Home

Follow your doctor's instructions, which may include:

• Drink plenty of water in the weeks after the procedure. This will help the stone pieces to pass.

• Resume daily activities within 1-2 days.

• You may experience some pain. Take pain medicine as directed to help manage any discomfort.

RESOURCES:

American Urological Association
http://www.auanet.org/

National Institute of Diabetes and Digestive and Kidney Diseases
http://www2.niddk.nih.gov/

CANADIAN RESOURCES:

Canadian Urological Association
http://www.cua.org/

Kidney Foundation of Canada
http://www.kidney.ca/

References:

Lingeman J, Matlaga B, Evan A. Surgical management of upper urinary tract calculi/electrohydraulic lithotripsy. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, PA: Saunders Elsevier; 2007: chap 44.

McKoy K. Extracorporeal shock wave lithotripsy for kidney stones. EBSCO Patient Education Reference Center website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81 . Updated November 11, 2009. Accessed August 10, 2010.

National Institute of Diabetes and Digestive and Kidney Diseases. Kidney stones in adults. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/stonesadults/ . Updated October 2007. Accessed August 10, 2010.