What is Ultrasonic Destruction of Kidney Stones?
Kidney stones are solid masses of crystalline material that are formed in the kidneys as a result of an elevated level of substances normally found in the urine such as calcium oxalate, cystine, phosphate, and urate. When the kidney stones become too large or don’t pass through the urinary tract, they can cause considerable pain and discomfort. Ideally, passing the stones naturally is the first choice of action, but if that proves unfeasible, other methods of removing the stones must be attempted—one being ultrasound shock wave lithotripsy (SWL).
Overview of Ultrasonic Destruction of Kidney Stones
Ultrasonic destruction of kidney stones is also referred to as extracorporeal shock wave lithotripsy (ESWL), and it involves applying shocks waves of sound energy, known as lithotripsy, to the affected area in order to break up the stones into tiny pieces. This allows the stones to then pass through the urinary tract and be eliminated in the urine without causing too much pain. The procedure is also called ultrasound fragmentation because during the application of the sound waves, the kidney stones become fragmented.
Benefits of Ultrasonic Destruction of Kidney Stones
The primary benefit of ultrasound shock wave lithotripsy (SWL) is that it is a lesser-invasive procedure than surgery—meaning that no incisions or invasive medical instruments are used. This makes ESWL one of the best options for removing kidney stones that don’t pass out of the body naturally. With SWL, only the targeted stones are affected without causing any damage to other organs or tissues.
In addition to ESWL, other alternatives for removing the kidney stones include ureteroscopy, percutaneous nephrolithotomy, and minimally-invasive laparoscopic surgery. Patients should discuss with their healthcare providers the relative advantages and disadvantages of these alternative approaches to formulate an optimal treatment plan.
Expected Results of Ultrasonic Destruction of Kidney Stones
Most patients enjoy the effectiveness of ESWL in removing kidney stones. Results may vary, however, depending on the size and location of the stones. Generally, it takes between one and two hours to complete the procedure.
For large or numerous kidney stones, two or more treatments may be necessary. After each procedure, patients are asked to stay, usually overnight, in the hospital to be monitored and to receive antibiotics to prevent any infection.
Gina, a 36 year-old accountant from Florida, noticed that she was passing more urine than usual and she was feeling some abdominal pain. Upon consulting her doctor, she was diagnosed with a large kidney stone. Her doctor recommenced ESWL and the procedure was completed as expected. A few days after the procedure, Gina felt considerably less pain and was able to pass urine more freely than ever before.
First Hand Experience
For me, the ultrasound fragmentation procedure was much less invasive compared to any other alternatives. My doctor informed me that the procedure would take approximately 2 hours and that I would have to stay overnight in the hospital, but apart from that, I felt little to no nerve as there were no incisions involved. I was amazed by the results as the pain and discomfort that I was feeling completely subsided.
Ultrasonic destruction of kidney stones is a non-invasive procedure that utilizes sound waves to break up the stones into tiny pieces. Most patients experience positive results from SWL with only one or two treatments needed for large or multiple stones. Additionally, the procedure does not cause any damage to surrounding organs or tissue, making it a very useful method for removing kidney stones without causing too much discomfort. However, patients should discuss the alternatives with their healthcare providers in order to formulate the best treatment plan.
Definition & Overview
There are different ways to remove or destroy kidney stones. One of them uses ultrasonic energy or high-frequency sound. This kidney stone remedy can be performed in two ways: first, the ultrasonic probe is inserted into the kidney to deliver high-pressure waves directly to the stone to destroy it. The other method is known as extracorporeal shock wave lithotripsy. The ultrasound or pressure wave is delivered from outside the body to break the kidney stones into small pieces. Most doctors today prefer the second method since it is non-invasive, but there are cases in which inserting a probe would prove to be more beneficial.
The kidneys are a pair of organs within the retroperitoneal space in the abdominal cavity. Their functions include:
Regulate electrolyte balance in the blood
Remove waste products resulting from metabolism
Contribute to maintaining the acidic and basic balance of the body
Secrete urea and ammonium through the passing of urine
Produce several hormones that are important for bodily functions, such as calcitriol that regulates calcium in the body and erythropoietin that controls the production of red blood cells. Renin, an enzyme also produced in the kidney, is involved in the regulation of the body’s mean arterial blood pressure.
What Causes Kidney Stones
Causes of kidney stone include the increased presence of mineral and acid salts inside the kidney could lead to the formation of small mineral deposits known as kidney stones, sometimes called renal calculi. One of the most common kidney stones causes is the concentration of urine that allows these minerals to bond together and harden. Kidney stones are classified according to their composition.
Calcium stones, which are mostly composed of calcium oxalate
Struvite stones, which typically form after urinary tract infections
Uric acid stones, which affect those who have gout
Cysteine stones, which are made up of certain amino acids
Early intervention for this condition includes drinking a large amount of water to help these stones pass through the urinary tract naturally and be excreted with the urine.
Treatment for Kidney Stones: Who Should Undergo and Expected Results
Kidney stone treatment using ultrasonic destruction is typically recommended for the treatment of kidney stones in men and women. It is considered when the condition can no longer be managed using conservative methods and if the stones have already blocked urine flow, resulting in the following symptoms:
Severe pain in the flank that travels to the abdomen and the groin area
Kidney stone pain during urination
Blood in urine
Nausea and vomiting
The ultrasonic destruction of kidney stones is a relatively simple and safe procedure. If the noninvasive procedure is performed, the patient gets to go home afterwards. The procedure lasts for about an hour. Meanwhile, patients who undergo the procedure that involves inserting an ultrasonic probe might need to stay in the hospital overnight. The expected outcome of these procedures is the passage and removal of fragmented stones through urination. In cases where the kidney stones are larger, the patient may need to undergo the same procedure several times until complete kidney stone removal is achieved.
How is the Procedure Performed?
If the procedure involves the insertion of an ultrasonic probe, the patient is asked to lie down on a water-filled cushion, positioning the body to easily target the stones. Anaesthesia is administered and the injection site is cleansed. The surgeon makes a small puncture below the rib area where a needle catheter is inserted. It is advanced until it reaches the area where the stones are located. To track the needle throughout the procedure, a fluorescent agent is also administered. A guide wire is then inserted through the catheter and guided into position. Another catheter is guided down into the ureter. Any stone lodged in the ureter may be pushed back into the renal pelvis. A nephroscope is also inserted to allow viewing and imaging. The nephroscope also allows the entry of the ultrasonic probe, which is then positioned against the stone. Once contact is made, ultrasonic energy is generated and it travels to the tip of the probe. The kidney stone absorbs the energy and gets fragmented into smaller pieces. Using irrigation and suction, these fragments are removed through the hollow probe. Once destruction of the stone is complete, the surgeon withdraws the nephroscope. The surgeon may perform another fluoroscopy to determine if proper drainage in the ureter has been achieved.
The second method also requires the patient to be sedated and placed on a water-filled cushion. A fluoroscopic x-ray system and fluorescent agent are used to locate the kidney stones. Once the stone is located, a focused shock wave is emitted from the machine known as a lithotriptor. The pulses are emitted at a slow rate and released several times until the shock waves fragment the stone into powder.
Possible Risks and Complications
The ultrasonic destruction of kidney stones is a safe procedure. However, there are certain minor risks and possible complications. These include:
Bleeding and infection among patients who undergo the invasive method
Pain, which is a common complaint among patients, especially during the first few days when the fragmented stones are voided
Adverse reaction to anaesthesia and staining agent
Rupture of the renal pelvis
Excessive bleeding following the external application of shock waves
Damage to the capillaries and interior parts of the kidney
Liou LS, Streem SB (2001). “Long-term renal functional effects of shock wave lithotripsy, percutaneous nephrolithotomy and combination therapy: a comparative study of patients with solitary kidney”. J Urol. 166 (1): 36. doi:10.1097/00005392-200107000-00008.
Macaluso JN, Thomas R (1991). “Extracorporeal shock wave lithotripsy: an outpatient procedure”. The Journal of Urology. 146 (3): 714–7.
Macaluso JN (1996). “Management of stone disease—bearing the burden”. The Journal of Urology. 156 (5): 1579–80. doi:10.1016/s0022-5347(01)65452-1.