Overview

Your doctor has found that you have a stone in your kidney or ureter. The ureter is the tube that connects your kidney to your bladder.

Kidney stones can be painful and cause infection or blood in your pee (urine). If the kidney stones are not removed, they can grow and damage your kidney or block your ureter.

You can read more about kidney stones on the NHS website.

If you have kidney stones, you might have a treatment called lithotripsy. This is a procedure to treat kidney stones.

The procedure uses shock waves to break your kidney stones into small, sand-like particles. These particles can then pass out of your body through your pee.

Benefits of lithotripsy

You have lithotripsy as a day procedure. This means that you can come to hospital, have the procedure,and leave hospital on the same day.

You do not need to have surgery or an anaesthetic. This means that you spend less time in hospital and can recover quicker.

Preparing to have a lithotripsy

• Allow at least 4 hours for your hospital visit.
• Drink normally and have a light meal before your appointment.
• Bring a dressing gown and slippers with you.
• Bring all the medicine that you usually take into hospital with you.
• Please do not wear any jewellery.
• If you plan to listen to or watch something on a device while you wait, please bring headphones.

If you think you might be pregnant, tell the nurse and radiographer (the person who gives you your treatment) as soon as possible. The treatment uses X-rays that could damage your baby.

Medicines

Do not make any changes to your usual medicines. Continue to take them, unless you've been told not to. Remember to bring your medicines into hospital with you.

Tell the doctor or nurse if you take any medicines that you buy from a shop or pharmacy. This includes any herbal or homeopathic medicines.

If you take any medicines that thin your blood, tell the lithotripsy office or stone nurse at least 2 weeks before your procedure. This includes antiplatelet medicines (such as aspirin or clopidogrel) or anticoagulant medicines (warfarin or rivaroxaban). You might need to stop them for a short time before your treatment.

If you are allergic to any medicines, please tell the lithotripsy office or stone nurse this too.

Smoking

If you smoke, we ask you to stop smoking before your treatment.

Smoking increases the risk of developing a chest infection or deep vein thrombosis (DVT) (a blood clot in a vein) after the procedure. It can also delay wound healing because smoking reduces the amount of oxygen that reaches the tissues in your body.

You can speak to your nurse or call our stop smoking service on 020 7188 0995 or email [email protected]

Arriving for your surgery

While you are at the hospital for treatment, a stone consultant is always available to give you advice and support.

When you arrive, please tell the receptionist or nurse your name. They ask you to sit in the waiting area or go for an X-ray to check the stone.

You sit in the waiting area until the nurse comes to prepare you for the procedure.

• We ask you to remove all your clothing and change into a gown and disposable underwear for the procedure.
• A nurse asks you some questions about your medical history. They also take your blood pressure to make sure you're ready for your treatment.
• We ask you to give a urine sample. We use this to check for an infection and make sure you are not pregnant.
• The nurses gives you some painkillers. These are usually tablets and a small suppository. This is a small cone or tube, which we put in your bottom. It melts to release painkillers.

During a lithotripsy

The radiographer completes the consent form with you, and reminds you of the benefits and risks of the procedure.

Please ask any questions you have. If you want to speak to the doctor again, please tell us.

1. You are marked with an arrow so the radiographer knows which side of your body needs treating.
2. We ask you to lie on the machine.
3. We put some warmed water on a plastic sheet underneath you.
4. We put small plastic stickers on your chest to monitor your heart rate during the procedure.
5. We use X-rays to find and target the kidney stone.
6. Then we put the lithotripsy probe under you on your skin to start the treatment.

When the lithotripsy begins, you feel shock waves entering your body. People have described this as similar to having a finger flicking against their skin. Some people find it painful, but others do not feel pain. Please tell us if you find this uncomfortable and we can give you more painkillers.

During the procedure, we deliver shocks to the stone at the rate of about 1 to 2 each second.

The treatment lasts about 40 minutes and delivers around 3,000 shock waves. They pass through your body to break the stone into pieces (fragments). These fragments then pass out of your body in your pee.

After a lithotripsy

After the procedure, we take you to a recovery area and give you some refreshments. You can leave hospital when you feel able to.

You need to spend the day resting. You should be able to carry out your normal activities the next day.

To flush out stone fragments, make sure you drink plenty of fluid (mainly water). Try to drink over 3 litres (5 pints) of fluid each day. It is a good idea to keep drinking this amount of fluid in the long term. This can help to prevent you from getting more stones.

Symptoms to be aware of

You might see blood in your pee for 1 or 2 days after the procedure. This is normal and will clear.

You might feel a bit sore after the procedure. You can take painkillers, such as paracetamol, to help with this.

Risks of lithotripsy

As with any procedure, there are risks when having a lithotripsy. Most people do not have serious problems.

The procedure bruises the kidney slightly, so you might see blood in your pee afterwards. This should clear after a few days.

A stone or stone fragment might be left in your body after treatment. If the stone or stone fragment drops into your ureter, it can get stuck and cause pain. If this happens, you might need more treatment to remove it.

You might get a urine infection.

A blood clot (haematoma) can sometimes form around the kidney, but this affects less than 1 in 100 people.

Giving your permission (consent)

Your doctor or nurse talks to you about the risks and benefits of a lithotripsy. They ask you to sign a consent form before you have the procedure. It is likely that you are consenting to several sessions of lithotripsy on the consent form.

We want to involve you in decisions about your care and treatment. If you decide to have a lithotripsy, we ask you to sign a consent form. This says that you agree to have the treatment and understand what it involves. If you would like more information about our consent process, please speak to a member of staff caring for you.

Other treatment options

Kidney stones in the ureter can be removed with a fibre-optic telescope. This procedure is called a ureteroscopy.

Larger stones can be removed with surgery. This involves the surgeon making a small cut (incision) in your back. You need to stay in hospital for longer after surgery and it takes more time to recover.

Please talk to your doctor or nurse if you would like more information on other treatment options.

Follow-up appointment

It's likely that you need more than one lithotripsy session to break the stones.

A few weeks after your have finished your lithotripsy sessions, you have a follow-up appointment in a clinic. We check how the treatment has worked.

We post you the follow-up appointment. If you cannot come to this appointment, please phone the stone unit on 020 7188 3220.