Surgical Options for Kidney Stone Removal

 Surgical Options for Kidney Stone Removal

The hardened deposits of minerals like calcium or waste products such as uric acid are called kidney stones. They initially are of small size but grow larger as more minerals attach to them. Drinking plenty of water is the best way to prevent kidney stones.

Some kidney stones exit from the body on their own through urine. However, bigger stones cause pain and get stuck in the urinary tract leading to an immediate requirement to remove the stone with the help of kidney stone surgery

Surgery for Kidney Stones 

The surgery might be required in conditions like:

  • The stone cannot exit the body via the urinary tract because of its size. 
  • There is extreme pain in the side and back just below the ribs. The pain may diverge to the lower abdomen and groin area.
  • The stone is blocking the discharge of urine from the kidney, causing pain and discomfort.
  • One has had multiple urinary tract illnesses in the past because of the stone.

The various surgical procedures are Percutaneous Nephrolithotomy, Nephrolithotripsy, Ureteroscopy, Shockwave Lithotripsy, and open surgery. 

1. Shock Wave Lithotripsy

  • It is the most common surgical procedure to remove kidney stones.  
  • It is usually an outpatient procedure. It is suitable for people having small or medium stones. 
  • The best thing about this surgery is that it is noninvasive. It implies that no incisions are required. High-energy shock waves (like sound waves) break the stones inside the kidney. 
  • The shock waves target the kidney stone causing them to break into tiny pieces. 
  • The treatment might not be adequate for people having larger stones.
  • As the procedure is noninvasive, the person can get back to normal activities within 2 days. 
  • However, the patient should drink lots of water after the procedure to help the stones or fragments pass.

2. Ureteroscopy

  • This procedure to treat kidney stones includes the doctor using a thin, flexible scope to locate and remove stones. 
  • No cuts are made in the skin in this surgical procedure.
  • A small telescope, called a ureteroscope, is passed through the urethra and bladder, which goes up the ureter to the point of the location of the stone. 
  • The procedure is generally performed under general anesthesia and lasts for one to three hours.
  • A small stone is removed easily from the ureter. However, for a larger stone or if the diameter of the ureter is thin, the stone needs to be fragmented with a laser. 
  • After the stone is broken into small fragments, these are removed.
  • The procedure may not be effective for patients with large stones because of impracticability. It may be difficult for patients with a history of urinary tract ailments. 
  • The procedure may require the patient to stay at the hospital overnight after the removal for recovery.

3. Percutaneous Nephrolithotomy or Percutaneous Nephrolithotripsy

  • Patients with large or irregularly shaped kidney stones undergo kidney stone surgery as per this procedure. 
  • The patients may include people with infections or stones that cannot be broken down into smaller pieces.  
  • This surgical procedure is specifically for people having stones bigger than 2 cm. 
  • Both procedures involve entering the kidney via a small incision in the back. 
  • Once the surgeon reaches the kidney, a nephroscope (a small fiberoptic camera) and other instruments are inserted through the cut. 
  • When the stone removal is done through the tube, it is called nephrolithotomy. 
  • However, if the stone is fragmented and removed, it is called nephrolithotripsy. 
  • High-frequency sound waves break the stone into fragments which are removed using a suction machine. 
  • The procedure takes about 20-45 minutes, but the patient must be in the hospital for 2-3 days. 
  • The patient may take up to a week to return to normal activities.

4. Open surgery   

  • Open surgery is a rare surgical option for kidney stones removal. 
  • This procedure is apt for large stones or stones that cannot be removed or fragmented with other treatments. 
  • Open surgery would be helpful in cases like stones stuck in the ureter, severe pain, the stone blocks the passage of urine, or one is bleeding or having an infection.
  • The stone is removed via the opening, where a stent is placed in the ureter to enable urine drain. 
  • The patient would have to spend more time in the hospital, and generally, it will take about a period of 4 to 6 weeks to heal after the surgery. 

In Conclusion

The procedures mentioned are some of the surgery options available for people having kidney stones. The kidney stone surgery depends on the intensity of the kidney stone problem. However, the important thing is to know when to consult a doctor and comprehend the entire situation before making a decision.


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