Oklahoma Lithotripter Associates
dba
Oklahoma Kidney Stone Center
5401 N. Portland, Suite 650
Oklahoma City, OK 73112
405-604-4160

Frequently Asked Questions

1. What is a Kidney Stone?
2. How long will I have to stay at the Center?
3. What do I wear when I come in for Lithotripsy?
4. How will I feel after the Procedure and when can I go back to work?
5. Will I feel any pain during the treatment?
6. How are Kidney Stones treated with Lithotripsy?
7. Who is a candidate for Lithotripsy?
8. What is lithotripsy?
9. How does the lithotripter work?
10. Should I pre-register before coming in?
11. What should I do before lithotripsy?
12. What can I expect during the procedure?

(Q)--What is a Renal Calculi-("Kidney Stone")?

(A)--Oklahoma can be associated with the term "Stone Belt". This region of the United States has a higher incidence of Kidney Stones due to hot weather and decreased fluid consumption associated with individuals working in the heat. Some kidney stones may be related to diet, possibly a high intake of rhubarb, spinach, leafy vegetables, tomatoes, chocolate, or coffee. They can also result from excess calcium in the blood. Causes of excess calcium in the blood include overactivity of the parathyroid gland in the neck (gland that regulates calcium in the body); a high intake of milk or vitamin D: prolonged lack of actividy, for example during a serious illness; and bone destruction such as by cancer. Your kidney's are located on either side of your spine just above your waist. They remove waste products from your body by making urine, which passes from each kidney to the bladder through a tube called the ureter.

Kidney stones build up from a chemical imbalance in the urine. They may be smooth and rounded or make an uneven "mold" of the inside of the kidney, completely filling up the small ducts. The irregular stones are sometimes called staghorns because of their shape, or infective stones because they happen during urinary tract infections. Stones also become problems when they leave the kidney and pass through the ureter, causing crampy pain, nausea, vomiting, and sometimes blood in the urine. Stones may also become stuck in the ureter, causing severe pain or infection.

Kidney stones are mostly seen in people of middle age. They are three times more common in men than in women. They tend to come back repeatedly.

Many Factors contribute to the development of kidney stones; heredity, dietary factors, and reasons unknown to modern medicine...

The renal calculi can cause severe pain as they pass from the kidney and travel down the ureter towards the bladder and urethra. Often these calculi become lodged within the kidney or ureter causing retention of urine within the kidney, severe pain, and/or infection. The Urologist will commonly place a stent (small tubing) up the ureter to allow urine to pass and provide relief for the patient until the stone passes or is removed. If the calculus does not pass by itself, the Urologist will use a surgical procedure called Cystoureteroscopy to obtain access to the kidney stone. The calculus can then be removed using a variety of methods. These methods may include grasping the calculus with a basket like device or even crushing the calculus using laser or sound waves. Patients undergoing Cystoureteroscopy usually go home within several hours following surgery. Minor discomfort is expected and often the stent will remain to allow fragments to continue to pass. The stent will be removed at a later date.

(Q)--How Long will I have to stay at the Center?

(A)--Plan on a six to seven hour stay from the time you arrive at pre-admission. The Actual treatment will take around a hour to an hour and a half. The extra time is for you ro be admitted, evaluated by the anesthesiologist and other physicians, and to recover.

(Q)--What do I wear?

(A)--Wear comfortable loose fitting clothing.

(Q)--How will I feel after the procedure and when can I go back to work?

(A)--People usually have soreness in the back or vlank area after treatment, this should disappear after several days. Most patients will pass blood in the urine after the procedure. This is to be expected. Some patients, especially those with large stones, exerience discomfort or intestinal upset as the stone particles pass. Discomfort levels vary from none to a level of pain requiring narcotic pain relievers; however, most patients have very little discomfort and mild pain tablets are usually all that are needed. It will take from two weeks to three months for most of the granular particles to be washed from the kidney.

Patients undergoing lithotripsy will normally be outpatients and be able to go home the same day. After treatment, a diet high in liquids will be recommended to aid in passage of the stone fragments. Total recovery time after is only one week or less. Most patients recover within 48-72 hours and can return to work.

(Q)--Will I feel any pain, during the treatment? (A)--You will have anesthesia administered prior to your treatment and you will be "pain free" during the treatment itself. This anesthesia will enable you to lie still so your stone can be localized and treated. Minimal movement on your part is important as this will make your treatment much more effective.

(Q)--How are Kidney Stones treated with Lithotripsy?

(A)--The purpose is to safely fragment your kidney or ureteral stones so the stone fragments can be passed naturally in your urine. The treatment is safe and complications of treatment are rare. In December of 1984 the Food and Drug Administration (FDA) approved the use of the Extracorporeal Shock Wave Lithotripsy (ESWL) for use in the United States. More commonly called just lithotripsy, this new technology offers a noninvasive technique to eliminate kidney stones from 80% of kidney stone sufferers with a return to their normal life-style within a few days.

The lithotripter - meaning "stone crusher" in Greek, was developed after six years of research by the Dornier Systems Company, a West German aerospace company. In February 1980, the company started the first cliinical trials of shock wave therapy for kidney stones.

The treatment begins with the patient being submerged in warm water in a very large specially design bathtub for approximately one hour for the treatment. Two x-ray machines assist in properly positioning the patient so the kidney stone receives the strongest impact of shock waves created by a special electrode. The shock waves are coordinated with your heartbeat.

Depending on your stone, you will receive from 800 to 2400 shock waves. Once the stone is in sandlike particles, you are carefully removed from the tub and transferred to a recovery area.

(Q)--Who is a candidate for Lithotripsy?

(A)--A preliminary evaluation by your urologist is required to determine if your are a candidate for lithotripsy treatment. Test include blood and urine analysis, bacterialogical studies, x-rays, and EKG, and possibly special studies of kidney function.

Patients with the following conditions are usually NOT considered candidates for lithotripsy:

  • The kidney with the stone has little or no function.
  • Urinary tract infection exists.
  • Marked obstruction of the urinary tract is present which would prevent passage of the stone fragments.
  • Female of childbearing years with lower ureteral stones.
  • Uncorrectable bleeding disorders.
  • Uncorrected high blood pressure.

    Other factors considered are the size, location, and number of stones, aw well as your overall physical condition. Your urologist is skilled at determining if you are good candidate for lithotripsy at this time.

    (Q)--What is lithotripsy?

    (A)--The most advanced method for the treatment of kidney stones. Lithotripsy is a Greek word meaning "stone crusher." Extracorporeal Shock-Wave Lithotripsy (ESWL), or lithotripsy, eliminates the need for surgery to remove kidney stones for those patients who are candidates for this treatment. In almost 90 percent of lithotripsy treatments, the kidney stone is eliminated with a single procedure.

    Lithotripsy also means a rapid recovery time, usually two to three days, compared to the weeks of recovery following surgery. A significant cost savings also results due to a shorter stay following the procedure.

    (Q)--How does the lithotripter work?

    (A)--The lithotripter uses shock waves to pulverize kidney stones inside the body. The shock waves are generated outside the body by a "spark plug" electrode which vaporizes a small amount of water. This water expands, generating the shock wave. Because water and body tissue have about the same density, the shock waves pass through both. When a shock wave enters the kidney stone, it disintegrates it and allows the fragments to pass naturally through the urinary system.

    (Q)--Should I pre-register before coming in?

    (A)--Yes. The Center Staff will attempt to contact you by telephone prior to the day of your scheduled treatment to obtain information for pre-admission. You will then learn what time to arrive at the Center. Anesthesia and staff prefer that patients pre-register at the Center one to two days prior to the procedure. Patients are encouraged to stop by the Center if possible, or they can telephone the Center and partially complete their registration. The Center's pre-procedure anesthesia questionaire can be accessed on the Center's web site www.surgeryok.com. Patients can print the form and complete it prior to arrival at the Center to bring with them.

    (Q)--What should I do before lithotripsy?

    (A)--Before treatment you will need certain test and x-rays. Usually, one to two days before treatment you will come to the Oklahoma Kidney Stone Center to have these tests performed. If you live out of town, your doctor may perform lab work and x-rays in his/her office and ask you to bring this results with you to the Center.

    Our business office will contact you by telephone prior to the day of your scheduled treatment to obtain information for pre-admission. You will then learn what time to arrive at the Center.

    Please observe the following pre-treatment guidelines:

  • Do not eat or drink anything 12 hours before the procedure.
  • Shower with antibacterial soap (such as Phisoderm, Hibclens or Betadine). These soaps can be purchased at a pharmacy, or you may ask for a sample at the Center when you come for lab work. Do not apply lotion to your skin after showering.
    The following medications contain ingredients which may interfere with you blood's ability to clot. We prefer that you discontinue these listed drugs 10 days prior to the procedure. However, please consult you physician about discontinuing these drugs and continue to take any other medications which you are taking under the advice of your physician.

  • Actabs
  • Advil
  • Aleve
  • Alka Seltzer
  • Aluprin
  • Anacin
  • Anaprox
  • Arthralgen
  • Arthritis Pain Formula
  • Arthritis Strength Bufferin
  • Ascriptin
  • Aspergum
  • Aspirin
  • Bayer
  • Bayer Time Release
  • Bufferin
  • Bufferin Arthritis Strength
  • Butazolidin
  • Celebrex
  • Codasa
  • Cogesic
  • Congesprin
  • Cope
  • Coricidin
  • Cosprin
  • Coumadin
  • Darvon Compound
  • Diurex
  • Doan's Pills
  • Dolor
  • Dristan
  • Duradyne
  • Duragesic
  • Duramed
  • Ecotrin
  • Empirin
  • Encaprin
  • Endocin
  • Equagesic
  • Excedrin
  • Feldene
  • Fenoprofen
  • Fiorinal
  • Formagesic
  • Four Way Cold Tablets
  • Heprin
  • Ibuprofen
  • Indocin
  • Indomethacin
  • Liquiprin
  • Lodine
  • Lovenox
  • Lyrica
  • Mediprin
  • Midol
  • Mobic
  • Momentum
  • Motrin
  • Nalfon
  • Naprosyn
  • Norgesic
  • Nuprin
  • Nyquil
  • Nytol
  • Oxycodone
  • Oxyphenbutazone
  • Pamprin
  • Percodan
  • Persistin
  • Phenaphen
  • Plavix
  • Pletal
  • P.M.S.
  • Premysyn
  • Propoxyphene & Aspirin
  • Quite World
  • Resolve
  • Robaxisal
  • Rufen
  • Sine-Aid
  • Sine-Off Sinus
  • Sodium Salicylate
  • Soma
  • Sominex
  • Stanback
  • Sure Sleep
  • Talwin Compound
  • Ticlid
  • Toradol
  • Uttram
  • Vanquish
  • Voltaryn
  • Warfarin
  • Herbal Supplements
  • Fish Oil
  • Garlic
  • Ginger
  • Ginko Biloba
  • Ginsent
  • St. John's Wart
  • Vitamin E

    (Q)--What can I expect during the procedure?

    (A)--On the day of the treatment you will receive an IV and either regional or general anesthesia. Your anesthesiologist will help you decide which type of anesthesia is appropriate for you. During a general anesthetic, you sleep during the entire procedure, while a regional anesthetic numbs your body from chest down and allows you to be conscious during the procedure. You will also be given a sedative which will make you drowsy.

    Next, a cystoscopic procedure (examination of the bladder and/or ureter through a lens may be performed, if necessary. Because of the large amounts of IV fluids you will receive, a catheter may be placed on your bladder to help flush your urinary system.

    You will then be placed securely on a supporting platform and lowered into a specially designed tub of water. Two x-ray units are placed next to you to show the precise location of the kidney stones on monitors viewed by the physician. You will be adjusted until the kidney is located at the shock wave focus point.

    The treatment begins as shock waves are coordinated with your heartbeat. Approximately 1,500 shocks are required to pulverize the stone. The treatment takes about an hour. After the procedure is complete, you will be taken to recovery until the anesthetic has worn off. Your doctor will decide if you can return home that day or should spend the night in a hospital.

     
    Locating the Stone 

    This is how the stone is located using two x-ray images to pinpoint the position of the stone.