INFORMATION FOR PATIENTS AND FAMILIES
        Postural Drainage with percussion 
        after having Lithotripsy
        The aim of lithotripsy is to break your stones into small 
        fragments.  With successful lithotripsy the fragments will range                                           Cavity 
        from the size of dust to small 2 mm pieces of gravel.                                                      within 
                                                                                                                  KIDNEY
        You will pass most of the fragments when you urinate.  
        However, sometimes these fragments settle in the lower area 
        of the kidney and need help to be flushed out; this is called 
        postural drainage with percussion (see Figure 1).
        •	  You may be asked to perform postural drainage with                                                     KIDNEY
            percussion after your clinic visit if you have remaining 
            fragments. Do it twice a day for 3-4 weeks.
        •	  On occasions you will be asked to perform postural drainage 
            with percussion after the lithotripsy treatment. Do it 2 times 
            a day for 7 days. This will help drain the part of the kidney                                       Ureter
            where the fragments tend to settle.                                     Figure 1
        WHAT TO DO FOR POSTURAL DRAINAGE WITH PERCUSSION
        STEP 1:  
        Drink 500 mL (16 oz.) of water (about 2 large glasses).  Wait 30 minutes before step 2, to prevent you 
        from feeling sick to your stomach.
        STEP 2:  
        Lie face down on your bed with your legs and pelvis on the bed and your upper body hanging over the 
        edge.  The angle between your body and your legs should be as close to a right angle as possible.  Use 
        your forearms to support yourself (see Figure 2 on back page). Some people will have difficulty getting 
        into this position, and some people will not be able to do it.
        STEP 3:  
        Using the side of a fist, you, or a friend/partner, should firmly percuss the area over the kidney about 
        20 times on the side that was treated.  (‘Percuss’ is to tap firmly with a fist.  ‘Kidney area’ is the soft 
        area in your back, just below the last rib).
        Form No. 72364 Postural Drainage with percussion after having Lithotripsy_August 2012
                                                                              NOTE:  
                                                                              The percussion should be firm 
                                                                              enough to help move the fragments, 
                                                                              but should not hurt or make your 
                                                                              skin red.  You should however feel 
                                                                              your body moving.  This procedure 
                                                                              is easier if done by someone else, but 
                                                                              you can do it yourself.
                                                                              STEP 4:  
                                                                              Wait in this position for 2 minutes.
                                                                              STEP 5:  
                                                                              Using a fist, percuss over the kidney 
                                                                              another 20 times.
      Figure 2: The photo shows one person percussion technique.                                                Cavity 
                                                                                                                within 
                                                                                                               KIDNEY
      STEP 6:  
      Do not stand up.  Turn and lie sideways on your bed 
      with the treated side up for 5 minutes in order to let the 
      fragments pass down into the ureter (the tube from the 
      kidney to the bladder see Figure 1).
                                                                                                                KIDNEY
      STEP 7:  
      Get up slowly so that you do not get dizzy.  Drink 
      another  500 mL of water to help flush out the kidneys.
      Urinate when you feel like it. Don’t be disappointed if                                                Ureter
                                                                                    Figure 1
      you do not see fragments; they may come later. 
      Stop the procedure if you start to feel unwell.  
      If you have any questions, please call the Lithotripsy Unit at 416 864 3030. 
                  This information is not intended as a substitute for professional medical care.  Ask your healthcare 
                                      provider about this information if you have questions.
                 St. Michael’s cares about your health.  For reliable health information visit St. Michael’s Patient and 
                  Family Learning Centre in the Queen St. lobby or online at www.stmichaelshospital.com/learn
    Form No. 72364 Postural Drainage with percussion after having Lithotripsy_August 2012