Name of the Procedure:

Anesthesia for Lithotripsy, Extracorporeal Shock Wave; with Water Bath

Summary

Lithotripsy with extracorporeal shock waves involves breaking kidney stones into smaller pieces using sound waves while the patient is in a water bath. To ensure comfort and immobility during the procedure, anesthesia is administered.

Purpose

This procedure is used to treat kidney stones that cannot pass through the urinary tract on their own. The primary goal is to fragment the stones into smaller pieces that can be easily passed or removed, thereby relieving pain and preventing further complications.

Indications

• Presence of kidney stones that are too large to pass naturally.
• Severe pain due to obstructive kidney stones.
• Persistent urinary tract infection due to kidney stones.
• Recurring kidney stones.

Preparation

• Fasting for at least 6-8 hours prior to the procedure.
• Adjustment or cessation of certain medications as instructed by the healthcare provider.
• Routine blood tests and imaging studies like X-rays or ultrasounds to assess the size and location of the kidney stones.

Procedure Description

1. Patient is positioned in a special tub filled with warm water.
2. Anesthesia is administered via intravenous line to ensure the patient is comfortable and immobile.
3. A device called a lithotripter generates shock waves that travel through the water and body tissues to reach the kidney stones.
4. The shock waves break the kidney stones into smaller fragments over multiple sessions if necessary.
5. Continuous monitoring of the patient’s vital signs throughout the process.

Duration

The procedure typically lasts about 45 minutes to 1 hour.

Setting

This procedure is generally performed in a hospital or an outpatient surgical center equipped with the necessary lithotripsy and anesthesia devices.

Personnel

• Anesthesiologist or nurse anesthetist to administer and monitor anesthesia.
• Urologist or specialized surgeon to perform the lithotripsy.
• Nursing staff to assist with patient preparation and monitoring.

Risks and Complications

• Common: Minor bruising, discomfort, or blood in urine post-procedure.
• Rare: Infection, internal bleeding, damage to nearby organs, or incomplete fragmentation requiring additional treatment.

Benefits

• Effective non-invasive treatment for kidney stones.
• Quick recovery time compared to surgical alternatives.
• Immediate relief from pain associated with kidney stones.

Recovery

• Patients are observed for a few hours post-procedure to ensure there are no immediate complications.
• Pain medication may be prescribed to manage post-procedural discomfort.
• Increased fluid intake to help flush out stone fragments.
• Follow-up imaging to check the success of the stone fragmentation.
• Restrictions on heavy lifting and strenuous activities for a short period.

Alternatives

• Ureteroscopy: Involves passing a small scope through the urethra to remove stones.
• Percutaneous nephrolithotomy: A small incision is made in the back to directly remove large stones.
• Medication: To dissolve certain types of smaller kidney stones.

Patient Experience

During the procedure, patients are under anesthesia, so they should not feel pain. Post-procedure, they might experience mild discomfort, bruising, or blood in the urine. Pain management measures and comfort protocols are in place to minimize discomfort and promote a quick recovery.