What is laser lithotripsy?

Laser lithotripsy is a procedure to treat kidney stones. It uses a laser to break the stones into very small pieces. These pieces can be removed during the procedure. Or they may pass out of the body in the urine.

You may be awake for the procedure. Or you may have medicine to make you sleep. Either way, you will not feel pain.

The doctor puts the laser and other tools into your urethra and moves them into the ureter and perhaps the kidney. The urethra and ureters are the tubes that carry urine through and out of your body.

The laser is then used to break up the kidney stones. The doctor may also place a small, flexible tube inside one of your ureters. It helps the pieces of the stone pass through your body.

Most people are able to go home the same day of the procedure.

Activity

• Rest as much as you need to after you go home.
• You may do your regular activities. But avoid hard exercise or sports for about a week or until there is no blood in your urine.

Diet

• You can eat your normal diet after lithotripsy.
• Continue to drink plenty of fluids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also be given instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• If you take medicine to stop the burning when you urinate, take it exactly as recommended. Call your doctor if you think you are having a problem with your medicine. This medicine may color your urine orange or red. This is normal. You will get more details on the specific medicine your doctor recommends.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• Be safe with medicines. Read and follow all instructions on the label.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take acetaminophen (Tylenol). Do not take ibuprofen (Advil, Motrin) or naproxen (Aleve) or similar medicines unless your doctor tells you to.
  • Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.

Heat

• Take a warm bath. This may soothe the burning.

Other instructions

• Urinate through the strainer the doctor gives you. Save any stone pieces, including those that look like sand or gravel. Take these to your doctor. This will help your doctor find the cause of your stones.

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what procedure is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your procedure. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your procedure. Your doctor will tell you if you should stop taking any of them before the procedure and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Laser lithotripsy is a way to treat kidney stones. This treatment uses a laser to break kidney stones into tiny pieces.

For several hours after the procedure you may have a burning feeling when you urinate. You may feel the urge to go even if you don't need to. This feeling should go away within a day. Drinking a lot of water can help.

Your doctor also may advise you to take medicine that numbs the burning. This medicine is called phenazopyridine. It is available by prescription and over the counter. Brand names include Pyridium and Uristat.

Your doctor may prescribe an antibiotic. This will help prevent an infection.

You may have some blood in your urine for 2 or 3 days.

Your doctor may have placed a small tube inside one of your ureters. Ureters are the tubes that connect the kidneys to the bladder. The small tube the doctor may have placed is called a stent. It may help the stone fragments pass through your body. Your doctor may remove the stent in a few weeks.

Most stone fragments that are not removed will pass out of the body within 24 hours. But sometimes it can take many weeks. If you have a large stone, you may need to come back for more treatments.

You may be awake for the procedure. Or you may have medicine to make you sleep. Either way, you will not feel pain. The doctor may use an X-ray to find the stone.

First, the doctor puts a thin viewing scope with small tools, a camera, and a laser into your urethra. The urethra is the tube that carries urine from your bladder to the outside of your body. Then the doctor moves the scope and tools through your urethra and bladder into your ureter. Ureters are the tubes that carry urine from your kidneys to your bladder. If needed, your doctor moves the scope into your kidney.

If the stone is large or is in your kidney, your doctor may need to make a small cut (incision) in your back and put a hollow tube into your kidney. In this case, the doctor uses the laser to break up the stone. Then he or she removes the pieces of the stone through the hollow tube.

Your doctor may also place a small, flexible tube inside one of your ureters. This tube is called a stent. It helps the pieces of the stone pass through your body. If you get a stent, your doctor will usually remove it in a few weeks.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your procedure may be canceled. If your doctor told you to take your medicines on the day of the procedure, take them with only a sip of water.
• Take a bath or shower before you come in for your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• You may need to give a urine sample. This is to make sure that you do not have an infection.
• Before the procedure, a health professional will clean the area around your urethra. He or she will also put numbing gel inside your urethra.
• You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.
• The procedure will take a few hours.