My kidney stones are fairly large. Any personal experiences with lithotripsy?

I saw the urologist today.  I have multiple stones in each kidney, and one of the stones is 6mm and another is 8mm (and the rest are still tiny).  He ordered an x-ray of the kidneys/ureter/bladder and said we will likely need to consider lithotripsy.  That, apparently, requires that I stop my Coumadin, but he didn't tell me anything else about it, and the info I was able to find in a Google search was pretty general.

So, for those of you who have had it done... was it inpatient or outpatient? what kind of pain medication were you given?  how long after the procedure did you have pain (hours or days)? how long were you off work (just a day or more than that)? did you have to have the procedure repeated? 

Anything else I might need to know?

 

Lora

p.s.  the urologist did confirm that fluids high in citrate (lemonade and orange juice) are helpful in preventing kidney stones AND that the calcium citrate we take does, indeed, help prevent stones (as opposed to calcium carbonate, which actually causes stones)

Lora,hubby had it done a couple years ago.  For him, it was outpatient.  They gave him Vicodin and Percocet.  He had stints put in, he said the worst past was having them taken out.  You may need some help that day for sure.  He is military and so he get two weeks convolscent leave.  I would imagine it may be more painful for men though,just because of how they reach the kidneys.  He has been great ever since.

My husband had lithotripsy done back in February. It was his second round of kidney stones. I don't remember the size of his stone but it was stuck about 3/4 of the way up his ureter, near his kidney.

First he had to have a stent put in because the pain was so bad. Then a week later he went back and had the lithotripsy done. It was outpatient. His took a few hours because the surgeon had to use the maximum number of blasts which was 3,000. The surgeon told me normally he doesn't need to use nearly that many. My husband did have bruising and pain afterwards on his back on the side they did the procedure. But the pain was nothing compared to the stone pain. He was sent home after the procedure and pushed fluids for two weeks and passed the pieces and then went back in to have the stent removed. All three procedures he had were outpatient and general anesthesia. He was back to work the day after his lithotripsy. 

I hope your procedure goes smoothly and you can get some relief. Kidney stone pain is definitely some of the worst out there. 

Nicky

I was in-patient for my procedure, however, that was some time ago.  I had a stent and a foley catheter post-op, both of them annoying - but not painful. 

'Excruciating' describes the pain for the stones, unless you wake up mid-procedure.  It felt like someone was swinging a baseball bat into my bac or using a jackhammer..  That's where any bruising and/or pain come from post-op.  That's not likely to occur though.

 

Best Wishes to you!!!

I had my stones removed through lithotripsy 9 years ago.  I also had been running 105 and 106 fevers for about 3 weeks  and went into labor a month early at the same time.  I was so happy they finally figured out what was wrong with me that the lithotripsy was nothing.  They placed a stint first under a local .  I felt almost 100 % better within a few hours.  Because it was so infected they waited a month to remove the stones.  That was done under general because they had such a difficult time getting the local to take effect.  I took pain meds that day, but I didn't need anything later.  Once the anesthesia wore off I was up and moving around without any problems.  Honestly, it was the easiest surgery I have ever had. 

One of my stones was 6mm. My lithotropsy was done outpatient in about an hour. Had some bruising and soreness. Had to catch stone particles in screen and container for them to review at follow up appt. I was not given any pain meds.  I was not working at the time but I believe you could go back in a few days after passing particles or maybe sooner.  

Hope you are feeling better soon.

I dealt with a very sudden, very severe kidney stone attack several years ago. In hindsight, I had some urinary symptoms but nothing indicative of stones. I went from attending a 2 hours spin class at 9:00 am to calling my husband home from work while I was laying on the bathroom floor while trying to get into the shower. I really thought (and wished) I was dying.

A CT scan showed a 1.3 cm (13 mm!!!) stone and several other smaller, non-obstructing stones. Urine cultures revealed a UTI and blood cultures revealed urosepsis. I was hospitalized for several days of IV antibiotics and they did a cystoscopy where they placed stents. My urologist felt that there was no way that I'd be able to pass the stone, even with the stents in placed. After three days of IV antibiotics and my pain and nausea were controlled (mostly from the cystoscopy and stent placing moving the stone backward where the ureter wasn't trying to contract and pass it along).

I was sent home, that was a Saturday. I was very run down and sick from the urosepsis and hospitalization. I was out of work that whole week recuperating and was scheduled for lithotripsy on that Friday. It was done as an outpatient. I was given IV Versed for the procedure and had no pain during the procedure at all and really was not very aware of the goings on. After the procedure, I was quite bruised and had some generalized soreness. I think I might have used some Ultram for the pain the next day, but it really was minimal. I went back to work on the next Monday with no residual effects from the lithotripsy. I kept my stents in for about three weeks before they were pulled.

Good luck!

This is my pro-lemon water to save your life speech.  Not really but it does apply to kidney stones so read on.

Lemon water is my go-to in life, it helps keep stones at bay, reduce appetite and increase metabolism and helps you lose weight.  Yes I read all that on a propaganda site pre-lemon water,  I take everything with a grain of salt.  I happen to love lemon, do I think it is a miracle cure-all for everything, no I don't.  I know it helps me, I am sure it does aid digestion and help regulate blood sugar, but who knows what impact that has on a rny patient.  I don't eat during the day and only drink very lemony (3 large lemons) in very dilluted iced tea.  No blood sugar crashes, no hunger, no nothing.  There are a bunch of websites that support what I just said, but who cares, I know how I feel and the fact I believe it helps me to maintain this way is all that matters.  I am not advocating the lemon water diet to anyone, but I do know it does help to drink massive amounts of water and lemon does help with preventing kidney stones, orange juice is not recommended.  I researched this because my bf had kidney stones here is the best site I found on listing what  you can do to prevent recurrence.

Oops I forgot to add my bf's cousin just had the lithotripsy laser thing done last year, she had to wait for the machine to come as it was one of those visiting treatment things.  She was so sick by the time it finally came and she got the stones broken up with the shock waves.  She was very sick and very underweight.  She still hasn't recovered completely, although I do believe she has some sort of underlying eating disorder, because she never regained the weight she lost and she was already rail thin before the stones.  I know she said it was painful, but not sure how bad, she had just had a baby the year before so her tolerance to pain was still pretty high.  She smokes and has a horrible diet, so I can imagine those are the causes.

Prevention

Anyone who has had kidney stones should try to prevent a recurrence. Some general observations include:

• The most important dietary recommendations for calcium stone risk are to increase fluid intake, restrict sodium, and reduce protein intake.
• Higher potassium intake can also lower the risk for calcium stones.
• A high-calcium diet does not appear to increase the risk for kidney stones as long as it also contains plenty of fluids, dietary potassium, and phosphate. (Increasing calcium alone may pose a modest risk for stones.)
• Patients should try to correct any dietary habits that cause acidic or alkaline imbalances in the urine, which promote stone formation.

Because different kidney stone types may require specific dietary changes, patients should work with their doctors to develop an individualized plan. Nutritional considerations are very important in preventing recurrences, and patients should comply with the proper diet.

Fluids (Water, Juice, and Other Beverages)

Good voiding habits, particularly frequent urination, are important. Therefore, of all the preventive recommendations, drinking enough fluids is the most important guideline for people with any type of kidney stones.

• In general, patients with calcium or uric acid stones should drink at least 10 full glasses of fluid each day (at least half should be water). They should drink one glass with each meal and drink fluids at night, even if it means getting up from sleep. Fluid intake should produce at least two-and-a-half quarts of urine each day.
• To prevent cystine stones, patients should drink even more water -- more than a gallon, or 16 8-ounce cups, every day. Patients should drink this amount at regular intervals throughout the night and day.

In all cases, patients need more fluid after exertion and during times of stress. If they drink enough, the urine should be pale and almos****ery, not dark and yellow.

Water. Although water is best, it may vary depending on its source. Variations in water itself may have different impacts. Water hardness (meaning how much calcium is in the water) generally plays only a small role in stone formation. By far, the amount of fluid intake is most important in preventing stones.

Juices and Specific Effects. Other beverages have various positive or negative effects, depending on the type of stone:

• Lemon Juice: Drinking one-half cup of pure lemon juice (enough to make eight glasses of lemonade) every day raises citrate levels in the urine, which might protect against calcium stones. (While orange juice also increases citrate levels, it does not lower calcium and it raises oxalate levels. Therefore, it is not recommended.)
• Cranberry and Apple Juice: Apple and cranberry juice contain oxalates, and both have been associated with a higher risk for calcium oxalate stones. Cranberry juice has properties that may increase the risk for both calcium oxalate and uric acid stones. On the other hand, cranberry juice helps prevent urinary tract infections and so may be helpful for reducing the risk for struvite and bru****e stones. (These stones are far less common, however.)
• Grapefruit Juice: A number of studies have found a risk for stones from drinking grapefruit juice.

Other Beverages and Their Effects on Stone Formation.

• Soft Drinks. Patients with stones should avoid cola drinks with phosphoric acid, because they can severely reduce citrate levels in the urine. Drinks containing citrate seem to be okay,
• Alcohol. Wine may protect against kidney stones. However, it is important to remember that beer and other alcoholic beverages also contain purines, which may increase the risk for the less common uric acid stones in susceptible people. Binge drinking increases uric acid and the risk for stones.
• Coffee and Tea. Some research has reported a lower risk for stones in people who drink tea and both regular and decaffeinated coffee.

Low-Salt and Low-Protein Diets

A low-sodium, low-to-moderate protein diet containing normal levels of calcium can help reduce the recurrence of stones compared to a low-calcium only diet.

Salt Restriction. Because salt intake increases the amount of calcium in urine, patients with calcium stones should limit their sodium intake to 3 g or less a day. Sodium may also increase levels of urate, the crystalline substance that can trigger formation of recurrent calcium oxalate stones. I

Protein Restriction. Protein increases uric acid, calcium, and oxalate levels in the urine, and reduces citrate levels. Diets high in protein, particularly meat protein, have been consistently connected with kidney stones. (Meat protein has a higher sulfur content and produces more acid than vegetable protein.)

Whether restricting meat protein alone without restricting sodium has any protective value is unknown. Most studies to date have found no difference in stone development between people with low and normal protein diets over 4 years.

Although the precise role of dietary protein in kidney stones needs further clarification, it is reasonable for everyone to consume meat protein in moderation. People with struvite stones, who need to reduce phosphates in their diets, should also cut down on proteins.

Role of Calcium

Calcium from Foods. Dietary calcium recommendations for kidney stone prevention need to be determined on an individual basis. A doctor will suggest calcium guidelines based on a patient's age, gender, body size, and type of stone. General recommendations for daily dietary calcium intake are: 1,300 mg of elemental calcium for teenagers, 1,000 mg for men and women ages 19 to 50 years, and 1,200 mg after 50. Most studies indicate that those who eat the recommended amount of dietary calcium (found in milk, yogurt, and cheese) have a lower chance of recurrence of stones than those who eat a low calcium diet. Therefore, a diet containing a normal amount of calcium, but reduced amounts of animal protein and salt, may protect against stones better than a low-calcium regimen.

Calcium Supplements. In general data do not support the use of calcium supplements in most situations. Calcium citrate is considered the best formulation, if supplements are needed. In a normal healthy diet, dairy products supply almost 80% of the daily calcium requirement. Calcium supplementation of doses between 200 and 400 mg may be used for people who are unable to eat an adequate amount of calcium in their diet. Dosages of calcium above 2,000 mg per day are clearly associated with the formation of stones.

Calcium Restriction in Certain Cases. Some patients, such as those whose stones are caused by genetic defects in which the intestine absorbs too much calcium, may need to limit calcium intake. More studies are needed to define this group precisely.

Fiber-Rich Foods and Their Compounds

Fiber may be beneficial for people with kidney stones. In addition, some fiber-rich foods may contain compounds that help protect against kidney stones. A wide variety of high-fiber plant foods contain a compound called phytate (also called inositol hexaphosphate, InsP6, or IP6), which appears to help prevent crystallization of calcium salts, both oxalate and phosphate. Phytate is found in legumes and wheat and rice bran. (Soybeans are also rich in phytate, but they are also very high in oxalates, so the overall effects of soy on kidney stones are not clear.)

Purine Restriction in People at Risk for Uric Acid Stones

A high intake of purines can increase the amount of uric acid in the urine. Those at risk for uric acid stones should reduce their intake of foods and beverages that contain purines.

Some diet and lifestyle changes may help prevent uric acid stones are:

• Avoid alcohol, anchovies, sardines, oils, herring, organ meat (liver, kidney, and sweetbreads), legumes (dried beans and peas), gravies, mushrooms, spinach, asparagus, cauliflower, and baking or brewer's yeast.
• Limit how much meat you eat at each meal.
• Avoid fatty foods such as salad dressings, ice cream, and fried foods

Oxalate Restriction in Hyperoxaluria

Most people with calcium oxalate stones should not avoid oxalate-rich foods unless the doctor specifically recommends a restrictive diet. Oxalate binds with calcium in the intestine, which may actually reduce calcium absorption. Some studies, in fact, indicate that eating foods containing oxalates and calcium together may reduce the risk of stones. Most of the foods that contain oxalates are very important for good health. Limiting oxalates may be particularly harmful in people with bowel disorders in which there is malabsorption.

• Foods high in oxalic acid include beets, soy, beet tops, black tea, chenopodium, chocolate, cocoa, dried figs, ground pepper, lamb, lime peel, nuts, parsley, poppy seeds, purslane, rhubarb, sorrel, spinach, and Swiss chard.
• Foods containing moderate amounts of oxalates include beans (green and wax), blackberries, blueberries, carrots, celery, coffee (roasted), concord grapes, currants, dandelion greens, endive, gooseberries, lemon peel, okra, green onions, oranges, green peppers, black raspberries, strawberries, and sweet potatoes.

Role of Fats

Certain fats may play a beneficial or harmful role in specific cases of kidney stones.

Restricted Fats in Patients with Stones Associated with Bowel Disease. Patients who have stones associated with short-bowel syndrome should eat foods with lower amounts of fats and oxalates. If patients with short-bowel syndrome eat too much fat, calcium may bind to unabsorbed fat instead of oxalates, increasing their oxalate levels and raising the risk of stone formation.

Fish Oil. Omega-3 fatty acids, found in oily fish like mackerel, salmon, and albacore tuna, have many health benefits, but the most current evidence suggests they do not help prevent kidney stones. A 2005 study of more than 200,000 adults found that increased omega-3 fatty acid intake did not reduce kidney stone risk.

Role of Vitamins

Vitamin B6. Vitamin B6, or pyridoxine, is used to treat people with primary hyperoxaluria, a severe inherited disorder. Patients should not try to treat themselves with vitamin B6. Very high doses (500 - 2,000 mg daily over long periods) can cause nerve damage, with loss of balance and numbness in the feet and hands. Food sources of vitamin B6 include meats, oily fish, poultry, whole grains, dried fortified cereals, soybeans, avocados, baked potatoes with skins, watermelon, plantains, bananas, peanuts, and brewer's yeast.

Vitamin C. Ascorbic acid (vitamin C) may change in the body to tiny crystals, called oxalates. These crystals do not dissolve. People with hyperoxaluria (too much oxalate in the urine) should avoid vitamin C supplements. Even for men with normal oxalate levels, higher consumption of vitamin C (more than 1,000 mg a day) may increase kidney stone risk.

Stress Management Techniques

Because of an association between stress and kidney stones, relaxation and stress management techniques may also be beneficial.

Preventing Recurrence

Dietary Considerations. People with kidney stones appear to be more sensitive to certain foods than people who do not form kidney stones. Therefore, vulnerable people should make specific changes in their diet. They should work with their doctors to develop a dietary plan that fits their individual situation. Drinking plenty of fluids is important for preventing recurrence of any kidney stone.

Indications for Drug Treatments. If dietary treatments fail, drug therapy may be helpful. A number of drugs are available to prevent recurrences of calcium oxalate and other stones. Medications that inhibit the formation of stones include allopurinol, thiazide, potassium citrate, and potassium-magnesium citrate. In addition, drug treatments can sometimes help prevent other complications related to stones, such as osteoporosis.

Correcting Underlying Conditions Known to Cause Kidney Stones. It is also important to treat and correct, if possible, any underlying disorder that may be causing stones to form. Such disorders include distal renal tubular acidosis, hyperthyroidism, sarcoidosis, and certain cancers. To prevent calcium stones that form in hyperparathyroid patients, a surgeon may remove the affected parathyroid gland (located in the neck). In most cases, only one of the glands is enlarged. Removing it ends the patient's problem with kidney stones.

More Information on This Topic

• Background
• Causes
• Risk Factors
• Symptoms
• Diagnosis
• Treatment
• Medications
• Other Treatments
• Complications
• Prevention
• References
• News & Features
• Reporter's File
• Expert Q & A
• Questions for Your Doctor
• Clinical Trials
• 5 Things to Know

View & Print In-Depth Report » Review Date: 8/27/2012
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