Lithotripsy - Destination India, Plus Glossary of Terms for Lithotripsy

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Lithotripsy - Destination India

Health Travel to India is a concept that is fast catching the fancy of the people all over the world. Nowadays, more and more people prefer India as a travel destination to fulfill all their medical needs. People come to India from Europe and America for treatments that are expensive in their countries while they found it reasonable in India. The vast difference in the cost of treatment between foreign countries and India has given rise to Health Travel to India.

The health care costs are very expensive and sometimes out of reach of the common masses in European and American countries. So they come on Health Travel to India where the doctors, facilities, infrastructure and technology are as good as abroad. India is dotted with some of the best hospitals and best specialist doctors in the world. People generally come for their treatment and stay back to travel and see India. Such tourism gives boost to medical as well as tourism industry of India.

What is Lithotripsy?

Lithotripsy is the use of high-energy shock waves to fragment and disintegrate kidney stones. The shock wave, created by using a high-voltage spark or an electromagnetic impulse outside of the body, is focused on the stone. The shock wave shatters the stone, allowing the fragments to pass through the urinary system. Since the shock wave is generated outside the body, the procedure is termed extracorporeal shock wave lithotripsy (ESWL). The name is derived from the roots of two Greek words, litho, meaning stone, and trip, meaning to break.

What is a kidney stone?

One in every 20 people develop a kidney stone at some point in their life. A kidney stone is a hard mineral and crystalline material formed within the kidney or urinary tract. Kidney stones are a common cause of blood in the urine and pain in the abdomen, flank, or groin. Kidney stones are sometimes called renal calculi. The condition of having kidney stones is termed nephrolithiasis or urolithiasis. (Nephrolithiasis literally means kidney stone-itis while urolithiasis means urinary stone-itis.)

What causes kidney stones?

Kidney stones form when there is a decrease in urine volume or an excess of stone-forming substances in the urine. The most common type of kidney stone contains calcium in combination with either oxalate or phosphate. Other chemical compounds that can form stones in the urinary tract include uric acid and the amino acid cystine.
Dehydration through reduced fluid intake or strenuous exercise without adequate fluid replacement increases the risk of kidney stones. Obstruction to the flow of urine can also lead to stone formation. Kidney stones associated with infection in the urinary tract are known as struvite or infection stones.
Men are especially likely to develop kidney stones, and whites get them more often than African American. The prevalence of kidney stones begins to rise when men reach their 40s and continues to climb into their 70s. People who have already had more than one kidney stone are prone to develop more stones.

A number of different conditions can lead to kidney stones:
Gout results in an increased amount of uric acid in the urine and can lead to the formation of uric acid stones. Hypercalciuria (high calcium in the urine), another inherited condition, causes stones in more than half of cases. In this condition, too much calcium is absorbed from food and excreted into the urine, where it may form calcium phosphate or calcium oxalate stones.
Other conditions associated with an increased risk of kidney stones include hyperparathyroidism, kidney diseases such as renal tubular acidosis, and some inherited metabolic conditions including cystinuria and hyperoxaluria. People with inflammatory bowel disease or who have had an intestinal bypass or ostomy surgery are also more likely to develop kidney stones.
Some medications also raise the risk of kidney stones. These medications include some diuretics, calcium-containing antacids, and the protease inhibitor Crixivan (indinavir), a drug used to treat HIV infection.

Pre-operative care for Lithotripsy:

Prior to the lithotripsy procedure, a complete physical examination is performed, followed by tests to determine the number, location, and size of the stone or stones. A test called an intravenous pyelogram (IVP) is used to locate the stones, which involves injecting a dye into a vein in the arm. This dye, which shows up on X ray, travels through the bloodstream and is excreted by the kidneys. The dye then flows down the ureters and into the bladder. The dye surrounds the stones. In this manner, x rays are used to evaluate the stones and the anatomy of the urinary system. Blood tests are performed to determine if any potential bleeding problems exist. For women of childbearing age, a pregnancy test is done to make sure they are not pregnant. Older persons have an EKG test to make sure that no potential heart problems exist. Some individuals may have a stent placed prior to the lithotripsy procedure. A stent is a plastic tube placed in the ureter that allows the passage of gravel and urine after the ESWL procedure is completed.

The process of lithotripsy generally takes about one hour. During that time, up to 8,000 individual shock waves are administered. Depending on a person's pain tolerance; there may be some discomfort during the treatment. Analgesics may be administered to relieve this pain.

Procedure of Lithotripsy:

Lithotripsy is a technique used to break up stones that form in the kidney, bladder, ureters, or gallbladder. There are several ways of doing this, although the most common is extracorporeal shock wave lithotripsy. The shock waves are focused on the kidney stone and break the stone into tiny pieces, which are passed out of the body naturally during urination. Throughout the procedure, the doctor can view what is happening to the stones through x-ray or ultrasound monitoring. This procedure prevents patient from having to undergo surgery to have the stones removed, which reduces discomfort, complications, hospital stay, costs, and recovery time.

Patient will usually be asked not to drink or eat anything for 6 hours prior to the procedure, or after midnight of the previous night, if the procedure is in the morning. If patient take regular medicines, patient should ask doctor if they are safe to take before the procedure. For instance, patient may be asked to stop taking aspirin and other drugs that interfere with blood clotting several days before.

On the day of the procedure, patient should wear comfortable clothes that are easy to remove, as patient will have to change into a surgical gown. The procedure generally takes from 45 minutes to 1 hour. In most cases, patient will be asked to lie on a table on top of a soft cushion, through which the shock waves are directed from the lithotripsy machine, called the lithotripter. Older machines require that patient immerse patient in a specially designed tub filled with water, and although less commonly used, these machines are still available today and are effective. Typically, patient will receive some form of anesthesia, and depending on the level of sedation, patient may feel a tapping sensation when the procedure begins. Since lithotripsy can cause mild discomfort, a mild sedative or painkiller is given beforehand. Patient should tell doctor if patient is pregnant, because lithotripsy must not be performed during pregnancy.

While most kidney stones are treated with this type of lithotripsy, not all stones can be treated this way. Sometimes a laser is used to pulverize the stone, but when a laser is used, the doctor must use an endoscope, which is a tube introduced into the body, via the urinary tract, to get close to the stone. The doctor may also access the stone from back into kidney, through a procedure called percutaneous lithotripsy. Laser lithotripsy is usually used when the stone does not respond to extracorporeal shock wave treatment or when it is in a place that is difficult to access. It requires a hospital stay and carries a slightly greater risk of complications than extracorporeal shock wave lithotripsy.

How successful is lithotripsy?

In those patients who are thought to be good candidates for this treatment, about 70 to 90 percent are found to be free of stones within three months of treatment. The highest success rates seem to be in those patients with mobile stones that are located in the upper portions of the urinary tract (kidney and upper ureter). After treatment, some patients may still have stone fragments that are too large to be passed. These can be treated again if symptoms persist.

Lithotripsy in India:

Medical tourism can be generally defined as provision of 'cost effective' personal health care in association with the tourism industry for your needing surgical healthcare and other forms of dedicated treatment. This process is being facilitated by the corporate sector concerned in health care as well as the tourism industry - both personal and public.

Medical or Health treatment package tourism has become a recurrent form of vacationing, and covers a broad range of medical services. It mingles free time, amusing and recreation together with wellness and healthcare packages.

The thought of the health holiday is to offer you and chance to get away from your daily habitual and come into a dissimilar calming neighboring. Here you can take pleasure in being close to the beach and the mountains. At the same time you are able to accept a compass reading that will assist you advance your life in terms of your health and general well being. It is like reconstruction and cleans up process on all levels - physical, psychological and expressive. Many people from the urbanized world come to India for the upgrading promised by yoga and Ayurvedic massage, but few consider it a target for hip substitute or brain surgical procedure. However, a nice blend of top-class medical expertise at attractive prices is helping a rising number of Indian corporate hospitals attract foreign your, including from developed nations such as the UK and the US.

GLOSSARY TERMS YOU MAY SEE IN LITHOTRIPSY