If the kidney stone or stone fragments are large, a small tube (stent) may need to be inserted into the ureter prior to lithotripsy. This is positioned via the urethra (the tube from the bladder to the outside) using a telescopic instrument called an endoscope. The stent allows the fragments to pass from the kidney without blocking the ureter. It will be removed in an outpatient clinic at a later date.
After the Procedure
Once awake the patient will be transferred from the bus to the hospital’s recovery room where their recovery is monitored. Once fully awake the patient will return to the ward and will be discharged later that day. Intravenous fluids may be administered during and immediately after the procedure to help flush out the kidney stone fragments. Once able, the patient will be encouraged to drink plenty of fluid to assist in this process. Often there is slight bruising around the area where the shock waves have entered the body, causing discomfort. Some discomfort may be also be experienced as the stone fragments pass through the urinary tract. If a stent was inserted there may be some urinary frequency (needing to pass urine frequently) and/or discomfort due to the stent irritating the ureter and bladder.The degree of discomfort experienced following the procedure will vary between individuals and can be influenced by the size of the residual stone fragments and the duration of the procedure. Pain-relieving medications can help to alleviate any discomfort experienced. Prior to being discharged from hospital, clear recovery and activity guidelines should be given. In some cases a course of antibiotics may be prescribed to help prevent infection.
It is usual for blood to be present in the urine for a few days after the procedure. It is important to inform the urologist promptly if the blood in the urine does not resolve or worsens, if a fever develops, if difficulty with urination is experienced, or there is increasing pain. Usually work may be resumed the following day, if the person is feeling able. If a stent has been inserted, a return to work will need to be discussed with the urologist.
Follow Up
A follow up appointment with the urologist is usually arranged for four to six weeks after the lithotripsy procedure. An x-ray is taken prior to this appointment to see if the procedure has been successful in clearing the kidney stone.(published with permission in writing from:http://www.southerncross.co.nz)
