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Kidney Stone Laser Lithotripsy 2024: Procedures, Benefits & Risks
Updated on
- Written by Paige Anderson, CRDH
Medically reviewed by
Dr. Maya Frankfurt, PhD
No one looks forward to passing a kidney stone. Kidney stones may take days or even weeks to pass on their own. Unfortunately, some stones may be too large to pass without medical help, or the anatomy of your urinary system may make it too difficult or painful.
Fortunately, there are a number of interventions to get rid of kidney stones safely with your doctor’s help.
Kidney stone laser lithotripsy is one of the newest approaches to treating stones. It involves using a laser to break the stone into tiny pieces, after which most stone fragments are removed with a basket device, preventing you from passing them later as with other kidney stone treatments.
Laser lithotripsy is a great option for stones that have become stuck in the ureter, which can become a serious medical emergency.
Kidney Stone Laser Lithotripsy
- Using a scope and laser in the urinary tract, laser lithotripsy can break up stones in the ureters or kidneys and remove the resulting pieces.
- Laser lithotripsy can be done while you are under general anesthesia or awake but numb.
- If your doctor tells you to discontinue any specific medicine before your procedure, it’s very important that you follow their instructions.
- You may be asked to fast before your procedure and bring a driver to take you home afterward.
What Is Kidney Stone Laser Lithotripsy?
If you’ve developed a stone that won’t pass or has become stuck, there are several types of procedures that can break kidney stones into tiny pieces, which can then be removed by the doctor or left to pass on their own.
A surgical approach is still appropriate in many cases, but we now have advanced technology to treat kidney stones with non-invasive or minimally invasive techniques.
These newer procedures may help you avoid major surgery and treat your kidney stones without leaving scar tissue.
Extracorporeal shock wave lithotripsy (ESWL) uses sound waves to break stones, leaving the pieces to pass on their own. It is totally non-invasive and a great option for many types of stones, but it has limitations.
Shock waves may not work on large patients, whose bodies may absorb too much of the energy from the sound waves. The specific composition[1] of the stone may also mean shock waves can’t effectively break it up, meaning ESWL won’t always be appropriate.
Laser lithotripsy ureteroscopy uses a small tube to deliver a fiber optic camera and laser through the urethra and upward into the urinary tract.
In place of sound waves, it uses a laser to break stones stuck in the ureter or the kidney itself.
The doctor may then remove stones and stone fragments using a basket device, making recovery easier. You won’t have to worry about more treatments if large pieces get stuck, or deal with the discomfort of passing all the pieces at home.
Laser lithotripsy frequently has better success rates than extracorporeal shock wave lithotripsy, and isn’t limited by body shape or stone size. Laser lithotripsy works on any stone composition, so it is a minimally invasive option in cases where ESWL isn’t.
Kidney Stone Laser Lithotripsy: How To Prepare
As with any medical procedure, undergoing laser lithotripsy is a health decision that takes some consideration and advance preparation.
Set Up A Chaperone
For laser lithotripsy, as with ESWL and surgical stone removal, you’ll likely be sedated or given pain medications that may leave you feeling groggy and disoriented after the procedure. If your doctor tells you to arrange for someone to drive you home, ask if they need to be on the premises throughout your procedure.
Find Out If You Should Stop Taking Your Medications
Be sure to tell your doctor about any prescription medicine or natural remedies or supplements you take, as these may interfere with some aspects of the procedure.
This is especially important if you take blood thinners or similar medicines, as these can cause complications during lithotripsy, and may even make them cancel the procedure if there is too much bleeding.
However, laser lithotripsy is considered the preferred method of stone removal for patients who can’t pause their blood thinners.
Be Aware Of Side Effects
Following any kidney stone treatment, you may have a slight amount of blood in your urine which turns it pink or reddish. It should fade after a couple of days.
Lithotripsy can cause a blood clot in the bladder, and you may pass a few small blood clots after your procedure. If you’re given urinary tract infection pain medicines, they may turn urine orange.
If you have a stent placed, it may cause some irritation in the bladder.
You may also feel nauseated due to sedation.
Be Aware Of Risks
Laser lithotripsy ureteroscopy has better success rates and lower risks of complications such as stone fragments becoming stuck when compared to shock wave lithotripsy.Risks during laser lithotripsy typically involve injury to the tissues of the urinary system. There have been cases of damage to the bladder as well as ureter stenosis, where the ureter becomes constricted following the procedure. However, these complications are rare and laser lithotripsy is generally considered very safe[2].
Each method has its pros and cons[3]. Your doctor will help identify the best approach with the lowest risk factors for your specific case.
Know When To Call A Doctor During Recovery
As with any medical procedure, it’s good to know what’s normal during your recovery. We’ll go over normal recovery in the next section.
You should call 911 for emergency care if you have lost consciousness, have chest pain or shortness of breath, or if you cough up blood.
You should also seek urgent medical care if:
- You see new or multiple blood clots in your urine.
- You have severe pain that does not improve with pain medications.
- You are struggling to pass urine.
- Symptoms persist for longer than your doctor told you they should.
Kidney Stone Surgery Laser Lithotripsy: What To Expect
Pre-Procedure Fasting
Your doctor may instruct you to limit fluids and foods several hours before your procedure. It’s important to follow their instructions exactly to prevent problems and avoid having your procedure canceled.
During The Procedure
You will likely be under general anesthesia or given an epidural to keep you comfortable throughout your lithotripsy procedure. An epidural also prevents spasms in the bladder that can lead to tissue damage.
Recovery
Your doctor will give you thorough instructions[4] to follow during recovery.
You can usually return to a normal diet and activities one to two days after your laser stone removal, unlike a surgical approach where recovery can take several weeks.
However, you should avoid exercise until there is no more blood in your urine and your stent has been removed.
If stone fragments are left behind, you may experience pain while these pass. Your doctor may give you prescription pain medicine to take during your recovery. Laser lithotripsy typically makes for a more comfortable process than other treatments, so you may not need many pain medicines afterward.
If your doctor prescribed antibiotics be sure to take the entire prescription exactly as instructed.
You may experience a burning feeling during urination for the first several hours after your lithotripsy. Drink fluids as recommended to help flush out your urinary system. Patients with liver disease may need to limit fluids, so be sure to ask your doctor for their recommendation.
Follow-Up Care
Laser lithotripsy may take more than one procedure. Specifically, if your doctor gave you a stent to help remaining stone fragments pass, you may need to return for stent removal after a few weeks.
Follow any diet changes your doctor recommends to prevent stones from happening again. Instructions usually include drinking plenty of water, and eating a kidney-friendly diet.
Conclusion
A laser lithotripsy procedure may be the best option[5] for treating stones in your kidneys or ureters. If you’re prone to blood clotting and can’t discontinue taking blood thinners due to high risks for complications like deep vein thrombosis, laser lithotripsy may be the best option for you.
Recovery is frequently more comfortable than with other treatments because it includes removing the stone fragments at the time of your treatment.
Your kidney doctor can help you explore your options and find the kidney stone treatment that’s best for you!
Frequently Asked Questions
ESWL uses sound waves and may not work for all body types, all stone compositions, or on very large stones. Laser lithotripsy is slightly more invasive, but won’t leave large stone fragments in the urinary tract, allowing for more comfortable recovery and better success rates.
Your doctor may tell you to stop taking some medications, especially if you take a blood thinner. However, laser lithotripsy is considered the best option for many patients who can’t stop taking their blood thinner.
It’s not unusual to see slight blood in your urine for a few days, but side effects from laser lithotripsy are typically rare and tolerable.
There is no compelling evidence that apple cider vinegar can shrink kidney stones. However, it may help reduce your risk for urinary tract infections. Apple cider vinegar gummies may give you a way to incorporate it if you’d like to try, and there are many brands to choose from.
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- Wiener, S., Deters, L.A. and Pais, V.M. (2012). Effect of Stone Composition on Operative Time During Ureteroscopic Holmium:Yttrium-Aluminum-Garnet Laser Lithotripsy With Active Fragment Retrieval. [online] 80(4), pp.790–794. doi:https://doi.org/10.1016/j.urology.2012.05.040.
- Zheng, J., Wang, Y., Chen, B., Wang, H., Liu, R., Duan, B. and Xing, J. (2020). Risk factors for ureteroscopic lithotripsy: a case-control study and analysis of 385 cases of holmium laser ureterolithotripsy. [online] 15(1), pp.185–191. doi:https://doi.org/10.5114/wiitm.2019.85360.
- Knoll, T., Buchholz, N. and Gunnar Wendt-Nordahl (2012). Extracorporeal shockwave lithotripsy vs. percutaneous nephrolithotomy vs. flexible ureterorenoscopy for lower-pole stones. [online] 10(3), pp.336–341. doi:https://doi.org/10.1016/j.aju.2012.06.004.
- Medlineplus.gov. (2020). Kidney stones and lithotripsy – discharge: MedlinePlus Medical Encyclopedia. [online] Available at: https://medlineplus.gov/ency/patientinstructions/000136.htm.
- Huang, J., Xie, J., Huang, X., Yuan, Q., Jiang, H. and Xiao, K. (2020). Flexible ureteroscopy and laser lithotripsy for renal stones 2 cm or greater. [online] 99(43), pp.e22704–e22704. doi:https://doi.org/10.1097/md.0000000000022704.
Written by:
Paige Anderson, CRDH
Medically reviewed by:
Medically reviewed by:
