Laser lithotripsy is a medical procedure that uses laser energy to break down kidney stones within the urinary tract, including the bladder, kidneys, ureters (tubes that carry urine from the kidneys to the bladder), and urethra (the tube through which urine leaves the body).
Laser lithotripsy is often performed by a urologist during ureteroscopy. The doctor inserts a flexible fiber with a laser at the end through a ureteroscope (a thin, lighted tube) into the urinary tract to break up the kidney stones. The stone fragments are then removed using a small basket or other instruments. No incisions (cuts in the skin) are needed for this type of surgery.
Sometimes, lasers are also used to break up kidney stones that a doctor is removing during percutaneous nephrolithotomy, a procedure that removes kidney stones through an incision in the back.
Laser lithotripsy is usually performed as part of a minimally invasive procedure. It is not considered major surgery.
The difference between laser lithotripsy and shock wave lithotripsy lies in how the kidney stones are broken up. Laser lithotripsy directly breaks up kidney stones inside the body using a laser, while shock wave lithotripsy breaks up kidney stones from outside the body using shock waves.
Laser lithotripsy is more effective at breaking up kidney stones that cannot be broken up by shock waves (due to the size, location, or hardness of the stone). However, since laser lithotripsy requires a surgical instrument to be inserted into the body, it carries some risks that shock wave lithotripsy does not.
Your doctor will give you instructions on how to prepare for laser lithotripsy. Following these instructions carefully can reduce the risk of complications. Before laser lithotripsy, your doctor may ask you to:
Sometimes, during a scheduled kidney stone procedure, the doctor may need to place a stent to widen the ureter and postpone the procedure for two to three weeks later.
During laser lithotripsy using ureteroscopy, your doctor will:
Laser lithotripsy usually takes one to two hours.
Since you will be under anesthesia, you will not feel any pain during the procedure. You may experience some pain or discomfort after the procedure.
After laser lithotripsy, the doctors will monitor you until it is safe for you to go home. You will need someone to drive you. Your doctor may prescribe pain medication, medication for stent discomfort, and antibiotics for a few days.
Benefits of laser lithotripsy compared to shock wave therapy include:
After laser lithotripsy, it is common to experience:
Complications of laser lithotripsy include:
Most people can return to their normal activities within about a week after laser lithotripsy. If you have a stent, certain physical activities may cause discomfort or blood in the urine. Ask your doctor about what to expect.
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