What side effects does lithotripsy have?

• The purpose of lithotripsy treatments is to relieve pain and help the body to function properly. There are multiple benefits for patients after surgery, making symptoms disappear completely.
• After the lithotripsy procedure, the chances of stone recurrence are significantly reduced, as long as patients follow the recommendations of the specialists.
• With the help of the holmium laser, stones of any type of composition and location within the renal, ureteral or bladder system are fragmented.

In cases where the stones are small enough, experts do not recommend resorting to lithotripsy surgery. This condition can be easily eliminated through urine by drinking plenty of water. If the stones cause the patient any pain, specialists prescribe medication to help remove the material and expel it in the urine.

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Prognosis following conservative treatment

As the stones are small or easily removed by medication, the chances of success are high. However, it should not be forgotten that this type of condition is usually genetic, so recurrence is possible. 

Therefore, it is necessary to take the preventive measures indicated by the specialists, mainly the care of the diet and fluid intake. If, despite conservative treatment, the problems persist, it is best to opt for lithotripsy.

As mentioned above, in cases where the stones are too large, surgical treatment is used to solve the problems of lithiasis. 

The following types of intervention can be used to remove urinary stones:

• Extracorporeal shock wave lithotripsy (ESWL): Consists of the fragmentation of stones by means of the extracorporeal application of energy from shock waves produced by a generator (electrohydraulic, electromagnetic or piezoelectric). This procedure is performed under analgesia and sedation of the patient and is minimally invasive. Despite its apparent advantages, it has disadvantages such as the possible need for several sessions.
• Percutaneous nephrolithotomy: In this case, the stones are removed using an endoscope inserted directly into the renal pelvis and calyces, which are the areas of the kidney through which urine passes.
• Ureterorenoscopic lithotripsy: This procedure is performed with an endoscope inserted through the urethra and bladder into the ureter.
• Stone resection: This is surgery in cases where the stone is of a size or shape that prevents it from passing and blocks the flow of urine, or when it is causing damage to the kidney or urinary tract. The process consists of removing the part of the kidney affected by the stones, exceptionally the kidney is removed completely, but only in the most serious cases.
• Endoureteral lithotripsy with holmium laser: This is the most advisable procedure, as it involves the removal of renal bodies without making any kind of incision in the patient. With the holmium laser, most of the residual material in the kidney is removed. Unlike extracorporeal lithotripsy, holmium laser lithotripsy allows most of the residual material to be removed during the procedure itself, whereas with extracorporeal lithotripsy it is the patient who has to remove the residual material in the following days.

Prognosis following surgical treatment

In most cases, kidney stone surgery (lithotripsy) leads to complete elimination of symptoms.

However, in rare cases, stones may recur. This is usually due to genetics, the patient is very prone, or in case of not having followed the relevant medical recommendations.

Therefore, the advice of specialists to avoid possible urinary tract infections or the reappearance of stones should be taken seriously, emphasising the consumption of a balanced diet and the care of the wounds until they are completely healed.

After any of the interventions the patient will notice changes in their body, these changes may vary, as well as the choice of the type of treatment that varies depending on the size of the stones, their composition and the place where they were lodged.

The purpose of treatments for kidney stone problems is to relieve pain and help the body to function properly. For this reason, the benefits for patients after lithotripsy surgery are diverse, although they can be summarised in the two fundamental pillars mentioned above.

The positive side effects to highlight are:

• It is a virtually non-invasive procedure and therefore does not normally require hospitalisation after surgery, but it is a treatment that alleviates the condition with a high level of success. This means that the patient, in addition to not having to undergo long-term surgery, also does not suffer from a long recovery or demanding care.
• Unlike other types of surgery, lithotripsy treatments have a minimal risk of complications. Similarly, the risk of infection is very low.
• In cases where stones are easy to locate and remove, recovery time can be reduced to a few days. After the procedure, the patient should rest for at least one day and can return to normal daily activities.
• After the procedure, the chances of stone recurrence are significantly reduced as long as patients follow the recommendations of the specialists, drink 8-10 glasses of water a day and follow a balanced diet, avoiding excess red meat, seafood, alcohol and dairy products.
• Symptoms after lithotripsy are usually completely relieved and therefore disappear. Negative side effects that may occur, such as urinary tract infection, are rarely prolonged and are usually eliminated by taking medication.
• This type of surgery is not limited by age, as the treatment can be adapted to anyone affected by the condition.

Overall, it is a very safe procedure but it should not be forgotten that there is the possibility of negative side effects, which is probably the reason you are reading this article, although these will disappear with a little more time for recovery.

Although the negative side effects that may appear after lithotripsy surgery disappear by allowing the body to rest and following the guidelines set out by the specialists, it should be remembered that they can still appear. 

The most common side effects include:

• Pain or discomfort: this is due to the time when the stone fragments pass through the urinary tract until they are finally expelled. The discomfort is due to the fact that the urethra is a structure that is not prepared to push the stones. However, it is a bearable discomfort as the pain would be much more acute if the stone were to remain in its original size.
• Blood in the urine: this is also a possible side effect after lithotripsy. It occurs due to the insertion of instruments and the passage of fragments through the renal organs. If bleeding persists for several days, it may be due to retained fragments that have not been broken down to a size small enough for the urine to continue to flow. If this occurs, specialists may choose to re-perform lithotripsy surgery. This is rare.
• Urinary tract infection: this is very rare and can occur after some procedures, such as extracorporeal shock wave lithotripsy. This is due to the possible presence of bacteria in the treated stones. This side effect can lead to other complications, such as the development of new stones due to pH imbalance in the urine. To avoid complications or the occurrence of this effect, specialists usually prescribe antibiotics to patients after the procedure. In the case of holmium laser lithotripsy, due to its characteristics, this is less common.
• Kidney damage: this type of side effect, although very rare, is one of the most problematic. It is due to the excessive formation of chemicals and various gas bubbles that can affect the structures in the area, in this case the kidney. The effects it causes are bleeding, oedema and swelling in or around the kidney. The main problem with this is that kidney function decreases, although it is still perfectly functional, and the problem resolves progressively with appropriate treatment.
• Gastrointestinal effects: in some cases it has been observed that after shockwave therapy (ESWT), due to the fact that patients with many stones may require several sessions, erosions may occur in the stomach and duodenum causing wear on the surfaces of the organs near the kidney, which may be due to friction or rubbing with other organs during the procedure due to the effect of the waves.
• Recurrence of stones, there is a possibility that stones may reappear in the kidney or other areas of the urinary tract after lithotripsy. This may be due to the fact that the smaller fragments are not completely removed from the body and act as foci from which new stones can be created. If the surgery and postoperative recommendations are carried out properly, this is very rare.

In addition to specific dietary guidelines and appropriate medical treatment, there are other useful general guidelines, which are usually sufficient to prevent stone formation both before and after lithotripsy.

• Increase daily fluid intake, drinking about 2 litres of water a day helps to maintain a good dissolution of urinary salts. This will cause urine to circulate rapidly, which is essential for proper control and prevention of urinary tract infection.
• Limit the intake of foods that have components that promote urinary stones and encourage the consumption of diuretic herbs such as parsley, nettle and dandelion.
• Do not eat meat excessively, around two portions a day.
• Regular consumption of dairy products is important to maintain adequate bone development, especially in young people, but excess is discarded and eliminated in the urine, which can lead to saturation that favours the development of stones, in this case calcium stones.
• Controlling urinary tract infections is a very important preventive measure, especially for women.
• Other recommendations: avoid constipation, do not hold back urine, avoid a sedentary lifestyle and empty your bladder immediately before or after sex.

In summary, early detection of stones in the body and subsequent choice of treatment by the urologist means that the chances of positive side effects are increased and the likelihood of the patient suffering any negative effects after lithotripsy is negligible.

Even so, it is clear that any complications can be alleviated with early detection and prolonged patient care through simple guidelines such as dietary care, hydration and taking medication prescribed by the doctor.

In addition, the use of the holmium laser to perform the lithotripsy procedure favours an early recovery and a much higher level of treatment efficacy compared to others.

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