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What are the Different Kinds of Kidney Stone Procedures?

By Vicki Watson
Updated May 17, 2024
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Kidney stones, which are hard mineral deposits that develop in the kidneys, cause significant pain to sufferers. Various kidney stone procedures exist for treating kidney stones. For example, ureteroscopy is a non-invasive procedure used on stones located in the central and lower areas of the ureter, but the high risk of damage from this surgery makes it less commonly used today. Extracorporeal shock wave lithotripsy (ESWL) is among the most common kidney stone procedures, and percutaneous nephrolithotomy is often used in cases of large stones or stones that are hard to reach with ESWL. Open surgery is rarely performed today, and it is generally reserved for extremely large stones that can't be addressed with less invasive methods.

Ureteroscopy is one of the least invasive kidney stone procedures, as no incisions are made, but because of the risk of damage during surgery, it is rarely performed. A small, fiber optic camera called a ureteroscope is passed through the tube, called the urethra, through which urine flows from the bladder during urination. The camera allows doctors to see the kidney stones and place them into a small basket attached to the ureteroscope.

Extracorporeal shock wave lithotripsy breaks up kidney stones utilizing shock waves, allowing the small pieces to simply move through the urinary track and out of the body. The patient lies on a cushion filled with water while a doctor directs high-energy sound waves through the body to break the kidney stones into small pieces which can then easily pass through the body during normal urination over the following days or weeks. This outpatient procedure takes about one hour.

When more aggressive kidney stone procedures need to be considered, doctors may opt to perform a percutaneous nephrolithotomy. A surgeon makes a 1-centimeter (about a 10-millimeter) incision in the flank, making this treatment more invasive than some other kidney stone procedures, but less invasive than open surgery. The doctor then threads a wire into the kidney to locate and break up stones using a laser. The stones are then removed using suction or a small grasping instrument. Percutaneous nephrolithotomy is used when less invasive procedures would likely be ineffective in remedying the problem.

When the patient suffers from very large kidney stones, open surgery may be the only option. Unlike less intrusive kidney stone procedures, open surgery entails a surgeon making a large incision to access the affected kidney. Additionally, the doctor also makes cuts into either the ureter or kidney to allow access to the troublesome stone. While typically very effective, the patient endures a considerably longer recovery time than with other treatment options, as a number of incisions are required for this procedure. This procedure also runs a higher risk of infection or kidney damage.

Kidney stone sufferers benefit from modern day technology that may more effectively relieve pain and remove stones. Such tools as small scopes, ultrasound and lasers usually make treating kidney stones less invasive than older surgery options while offering efficient resolution to the issues. Patients requiring such surgery should discuss all options, risks and potential complications with their doctors before deciding upon a specific procedure.

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