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[litho- + -tomy]
The incision of a duct or organ, esp. of the bladder, for removal of a stone.
SEE: lithotomy position

Noninvasive measures and prescribed analgesic agents are provided to relieve pain. Fluid balance is monitored, and, unless otherwise contraindicated by cardiac or renal status, fluid intake of 4 L/day is recommended to maintain a urine output of 3 to 4 L/day, which aids in the passage of small calculi (up to 5 mm in diameter) and prevents ascending infections. Supplemental IV fluids are provided if the patient is unable to tolerate the required volume by mouth. Vital signs and laboratory studies are monitored for signs of infection, and prescribed antibiotics are administered. The health care professional prepares the patient for lithotripsy or surgery, as indicated, by explaining postoperative equipment, care procedures, and expected sensations. Any incisions are assessed for drainage and healing; the character and amount of drainage are documented, usually via a ureteral catheter or nephrotomy tube (which should never be irrigated unless specifically prescribed). Using aseptic techniques, the health care professional protects surrounding skin from excoriation by redressing frequently. All urine is strained for evidence of stones, and any solid material is sent for analysis. Splinting the incision with a small pillow assists the patient to mobilize and to carry-out pulmonary hygiene. Based on laboratory analysis of the stone, treatments are prescribed to prevent recurrence.

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