Post-Surgery Recovery: Managing Dizziness and Concerns About Future Kidney Stones

Extracorporeal Shock Wave Lithotripsy (ESWL)

Hello Dr.
Hsu, I previously consulted you regarding my father who underwent ureteroscopy for stone removal.
The surgery has been completed, but he has been experiencing weakness and occasional dizziness for nearly 20 days post-operation due to general anesthesia.
Is this normal, and are there any ways to alleviate the dizziness? Additionally, if the right kidney requires extracorporeal shock wave lithotripsy, will he need dialysis in the future? I have heard of cases like this and am a bit concerned.
Thank you.

A San, 40~49 year old female. Ask Date: 2008/06/29

Dr. Xu Weikai reply Urology

Hello, after ureteroscopy for stone removal, if there are no special circumstances, you should get out of bed and move as soon as possible to regain your strength.
Generally speaking, if you lie in bed for 3 days after surgery, it may take about a week to recover your original strength.
If you lie in bed for more than a week, it could take up to a month to recover, and in severe cases, rehabilitation equipment may be needed to assist.
Your father's situation may be due to lying in bed for too long, leading to a decline in physical strength, which can cause symptoms like dizziness and low blood pressure when standing.
If he hasn't been lying down for too long, then other cardiopulmonary issues should be considered.

As for extracorporeal shock wave lithotripsy, if performed by a physician, it is usually very precisely targeted at the stones, and there should not be any kidney damage.
Current research indicates that renal hypertension following shock wave lithotripsy is generally temporary; in other words, with proper targeting and technique, permanent kidney damage is rare.
Dialysis is generally considered to have little relation to shock wave lithotripsy.
You may want to inquire with the nephrology society about how many people require dialysis due to complications from stone removal surgery.
Note:
1.
Poor targeting can indeed cause kidney damage (such as renal hematoma), but this is rare with normal procedures.
2.
There are occasional case reports from abroad indicating severe complications, such as damage to the lungs, liver, or spleen, due to improper technique or poor machine positioning.
If there are any unclear points, feel free to ask again for further discussion and research.

Sincerely,
Dr.
Hsu Wei-Kai
Director, Urology Department
Taitung Hospital, Department of Health, Executive Yuan

Reply Date: 2008/06/29

More Info

Post-surgery recovery can be a challenging time, especially after procedures such as ureteroscopy for stone removal. It's not uncommon for patients to experience lingering symptoms such as dizziness and fatigue for several weeks following surgery, particularly when general anesthesia has been used. Here’s a detailed overview of what you might expect during recovery, how to manage dizziness, and considerations regarding future kidney stones.

Understanding Post-Surgery Symptoms
1. Dizziness and Fatigue: After undergoing general anesthesia, it is normal to feel weak and occasionally dizzy. This can be attributed to several factors:
- Anesthesia Effects: General anesthesia can affect your central nervous system, leading to temporary disorientation and fatigue.

- Hydration and Nutrition: Post-operative recovery often requires adequate hydration and nutrition. Dehydration or inadequate caloric intake can exacerbate feelings of dizziness.

- Pain Medications: If you are taking pain medications, they may have side effects that include dizziness or sedation.

2. Management Strategies:
- Hydration: Ensure you are drinking plenty of fluids. Aim for at least 2-3 liters of water daily unless otherwise instructed by your physician.

- Balanced Diet: Focus on a balanced diet rich in vitamins and minerals to support recovery. Foods high in potassium, magnesium, and iron can be particularly beneficial.

- Gradual Activity: Start with light activities and gradually increase your level of physical activity as tolerated. Avoid sudden movements that could trigger dizziness.

- Rest: Ensure you are getting enough rest. Your body needs time to heal, and adequate sleep is crucial.

Concerns About Future Kidney Stones
1. Risk of Recurrence: Patients who have had kidney stones are at a higher risk of developing new stones in the future. The recurrence rate can be as high as 50% within five to ten years. Factors contributing to this include:
- Dietary Habits: High sodium, oxalate, or protein intake can increase stone formation.

- Dehydration: Not drinking enough fluids can lead to concentrated urine, which promotes stone formation.

- Metabolic Factors: Certain metabolic disorders can predispose individuals to stone formation.

2. Preventive Measures:
- Hydration: As mentioned, maintaining high fluid intake is crucial. Aim for at least 2-3 liters of water daily.

- Dietary Modifications: Depending on the type of stones previously formed, dietary changes may be necessary. For example, reducing oxalate-rich foods (like spinach and nuts) can help prevent calcium oxalate stones.

- Regular Monitoring: Regular follow-up appointments with your healthcare provider can help monitor kidney function and detect any new stones early.

3. Concerns About Dialysis: The need for dialysis typically arises from significant kidney damage or failure, which is not a common outcome from having kidney stones unless there are complications such as obstruction or infection. If your kidney function remains normal and you manage your stone risk factors, the likelihood of needing dialysis is low.

Conclusion
In summary, feeling weak and dizzy after surgery is relatively common and can be managed with proper hydration, nutrition, and gradual activity. It's essential to maintain follow-up care to monitor for any future kidney stones and to implement preventive measures to reduce recurrence risk. If symptoms persist or worsen, or if you have concerns about your kidney function, it is crucial to consult your healthcare provider for further evaluation and tailored advice.

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