Laser lithotripsy is done to break the kidney stones in the urinary tract with the help of ureteroscope which is passed into the tubes of urinary tract. The laser breaks the stone into sand like particles which are then flushed out in the urine. This procedure doesn’t require any incision and patient can go back home within 24 hours. This procedure is done when other non-surgical treatments have failed or if kidney stones are too large to pass, irregular in shape or causing bleeding or damage to the surrounding tissue.
Kidney stones may stuck anywhere in the urinary tract, kidney and the ureter. Ureter is a tube that carries urine from kidney to the bladder and when the stone is trapped in the ureter it can cause a blockage and back up urine into the kidney that can cause severe pain and discomfort. In Laser lithotripsy, kidney stones are break apart into small particles in order to make it easy for them to pass through the ureter. These pieces will either be removed by using a special basket by surgeon or left in place where they will move from the ureter to the bladder, then pass out of the body through urine. This treatment procedure can be used if other non-surgical treatments have failed or if kidney stones are:
• Too large to pass
• Irregular in shape
• Causing bleeding or damage to nearby tissue
• Multiple stones
At the time of consultation, doctor will perform some tests that may include physical exam, blood tests, urine tests, X-rays, electrocardiogram (EKG) etc to determine the overall health of the patient, size, type and exact location of the stones. Patient should inform doctor about any allergies, medications or supplements he/she might be taking to avoid any complications during the surgery. Patient will be advised not eat or drink after midnight prior to the surgery.
During the surgery, patient will be given general anesthesia to make him/her fall asleep through the procedure. Surgeon will place an instrument with long thin tube called ureteroscope to view the urinary tract, see the exact location of the kidney stones and pass surgical tools to the stone. The scope will be inserted in urinary tract through the urethra to the bladder, into the ureter and then to the stone. After detecting the stone, doctor will send a fiber through the scope to the stone. This fiber creates a laser beam to break up the stone. Pieces of broken stone will be removed using a basket which is passed through the scope. Other remained small pieces will gradually pass out through the urine. Surgeon may also place a temporary stent in the ureter that will keep the ureter open, improve urine flow, and help the stone pieces pass. The stent will be removed after a few weeks. This whole surgery can take 45 minutes to 1 hour.
In some cases, patient may feel pain or discomfort due to bladder spasm after the surgery which can be managed by medications and will be given antibiotics to prevent infection. Follow up visit and X-ray is required to look for remaining stone fragments or confirm the stent placement. The complete recovery can take 1-2 weeks.
Every surgery has some risks and complications. Some of the common risk involved in laser lithotripsy may include:
• Increased blood in the urine or hematuria
• Urinary tract injury
• Stent pain or dislocation
• Residual stone fragments that may require additional procedures
• Scarred tissue within the ureter
• Ureteral avulsion
Patient should contact doctor right away if any of following problem occurs:
• Difficulty in urinating
• Unmanageable pain
• Redness, infection, or foul drainage
• Persistent vomiting or nausea
• New or worsening symptoms
• Fever or chills