Lithotripsy...will I need a stent?

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Hello. I posted a few weeks ago about my problems with kidney stones and my upcoming Shockwave Lithotripsy. The procedure is taking place in 2 days, and I've got some concerns about whether a stent will need to be put in place.

The lithotripsy is for an 8mm stone in my left kidney. The stone hasn't given me any problems (yet), but I passed a stone from that kidney 6 months ago. The lithotripsy is simply preventative. I've had x-rays and a CT scan and my kidneys are very healthy despite the stones (I have multiple small stones in my right kidney too, but they're small enough to be left alone). For this reason I'm quite confident that a stent won't be necessary, but will it depend on the success of the procedure? I really, really do not want a stent - I have a lot of anxieties surrounding the feeling of needing to urinate frequently, and by the sounds of it, a stent is a sure-fire way to have this feeling!

I should also mention that I'm in the UK and having the procedure done on the NHS, which may be slightly different to the US (I know in the US it's common for Lithotripsy patients to be under anaesthetic, but as far as I'm aware, I'll be awake for the duration of the procedure). 

Like I said, the procedure is a few days away, so a prompt response would be greatly appreciated! Thank you.

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  • Posted

    I don't think you'll need a stent.

    I had lithptripsy about a year ago and they told me that the first session hadn't done enough so they booked me in for a second session and sent me away without any stent or mention of it.

    As it happened, by the time I got back for the second session, the stone was gone so I didn't need it.

    I didn't get a general anaesthetic for the procedure but they did give me tramadol (I think) which was about good enough to cope with the session. I felt OK until towards the end when I was feeling slightly sick but they kept telling me how long there was to go and it was something to look forward to.

    As soon as the session ends, I was OK and rested for the remainder of the day.

    Let us know how you get on.

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  • Posted

    Hi, I've had lithotripsy several times on the nhs, it's a really straightforward procedure. You get given a painkiller (usually diclofenic suppository) and change into a gown. The machine is ultrasound I believe which allows them to find the exact placement of the stone. The treatment starts slowly and then gets more intense but it's bearable, it can be stopped at any point if it's too intense. They have a new machine at my hospital so I can see the timings and intensity but if it's the old style then they tell you.

    they can tell immediately if the procedure is working so they know whether to book you in for another appointment.

    afterwards you feel a little sore and bruised but again, it's bearable and you need to drink a lot to flush the fragments out and will pass bloody urine at first which is completely normal. 

    As for needing a stent or feeling like you need to urinate all the time, neither of those should occur. It really is simple and effective. You'll be fine. 

    Hope this helps a little 

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  • Posted

    I had that procedure in 1998. I had a shot in the arm and I don't remember anything until I woke up. After it was over, I passed a lot of stones.  It was crazy! No pain. Then I went home and took it easy. I felt a little bruised that's all. I've never had a stent but knew someone who did ( not with lithotripsy)    She said it was painful.  I don't think you will need one with this. 
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  • Posted

    Thank you so much everybody, all of you have provided really useful advice and I feel much more confident now! Fingers crossed it works first time and I can be stone-free (at least for the foreseeable future!)
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  • Posted

    While not for your problem I had a stent fitted. The urologist wanted to examine my kidney internally but could not get far enough up - as it were.

    The stent was fitted under general anaesthetic thank goodness and I was in incredible pain afterwards but only when passing urine.  So much so that I was kept in for 2 further days.  The stent itself was then not too uncomfortable and did the trick. On a subsequent visit she was able to see everything that she wanted!  And removed the stent without problem

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  • Posted

    I have had many lithotripsy procures in the past (about 10). Twice after the procedure a stent washout in. AWFUL experience!! They were each left in for a few weeks then (painfully removed). I don't know whether unlucky or it was too large but I was uncomfortable constantly when the stents were in. Any time since, no stent, no problems! The fragments passed out fine on their own. If you can avoid a stent do! 
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  • Posted

    I had the procedure this morning. It was far easier than I expceted - the worst part was the pain relief injection that I had in my bum cheek, which was very sore! It lasted 25 minutes, and the pain was quite bearable. It was worst around the middle of the procedure, but by the end I couldn't even feel it really. I haven't had any pain since I got home, except for if I'm in an awkward position. I've passed a lot of blood when urinating but that's about it.

    One thing I am a bit puzzled by is that I have to go back next week for more, and the nurse told me it's normal for them to do 3 sessions - will this really be necessary? I thought 1 session was normal, with the possibility of another if it doesn't get the whole stone. I don't mind having a second session, but I'd prefer not to have a third. 

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    • Posted

      Three sessions is just the standard number they give, I had 5-6 sessions in a row when I first had treatment. It depends on the type of stones and how quickly they break up, if you drink as much as possible and flush the fragments out then you may not even need a second session. Unfortunetly they can't tell until you're there next time. I've got my first session next Thursday, I'm hoping I'll only need the one too as I find the anticipation of it worse than the actual process. Glad it all went well for you tho smile
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  • Posted

    Back again!

    So I had my first session of lithotripsy last week with no complications. I passed a little blood the day after, but passed no noticeable fragments and minimal pain.

    I had my second session yesterday, which weirdly felt really different. I've passed no blood or fragments, but I had to get up to pee about 4 times last night and I've needed to go probably once an hour all day today. I've been drinking a lot of water (2-3 litres) but I usually drink that much and don't have to go this often. Could this be a result of the lithotripsy?

    My next session is a month away and that was the next available appointment, so I'm a little worried about the gap in between. They've told me 3 sessions is the minimum, but I'm really hoping I won't need a lot more than that sad

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  • Posted

    OK, so far so good, but you might not yet have completed your sessions and the end result will come when the stone has completely passed so stick with it. This is the least-invasive treatment option for you at the moment.

    Your frequent need to pass water might be tiny fragments passing. Mine passed some time after the first session of lithotripsy and I did not spot the fragments coming out but they must have done so because there was no stone to be found when I went back for my planned second session.

    How are you now? Has the urgency passed? Don't want to get your hopes up but the stone may well have passed and you might find that you don't need the third session.

    Keep up with the water. If there are fragments still there, the water will help to try and flush them out. If there are no fragments then the water will not do you any harm and it will help to prevent new stones forming..

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    • Posted

      Thanks for your reply, sheffnet.

      I don't feel great, the urgency is still there and I woke up a few times last night with it again. I have no idea how much the stone has broken up so I can't be sure if it's in a gravel-like state yet. As I mentioned, this second session felt quite different...it didn't really hurt much and I've had no pain whatsoever since. It makes me wonder if the second session made any difference at all! The person carrying out the procedure gave me no indication of how well the stone is responding to treatment, so I'm sort of in the dark.

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