Kidney Stone Removal Procedures

Although they're not life-threatening, kidney stones are one of the most painful ailments you can experience--and unfortunately, they're a relatively common ailment for many. Fortunately, there are several ways to treat a kidney stone and get it to pass through the body quickly and easily. Most treatments don't require surgery, and those that do are not especially invasive.

Identification

• Usually urine flows out in a gentle stream. This doesn't just happen; chemicals in the urine prevent other chemicals from crystallizing, such as calcium or phosphate. If these crystal-preventing chemicals aren't working, little urine crystals form. These crystals may pass unnoticed or they may lodge in the kidneys or ureters (the tubes that link the kidneys to the bladder). Crystals that get stuck are called "kidney stones."

Conservative Treatment

• One way to remove a kidney stone is simply to flush it out. Drinking lots of water (2 to 3 quarts per day) will form enough urine to push the stone down the urinary tract and out of the body. While the patient is drinking all this water, he can take painkillers to make the process somewhat less agonizing. Physical activity, along with water, can also help dislodge the stone, although the pain associated with kidney stones can make physical activity hard to achieve.

Extracorporeal Shock Wave Lithotripsy

• Extracorporeal shock wave lithotripsy (ESWL) is the most common procedure to remove kidney stones that are too large to flush out of the body. It doesn't require surgery; instead, a machine sends shock waves into the abdomen, where they break up the kidney stones until the pieces are small enough to pass through in the urine. While ESWL doesn't involve a scalpel, it does have side effects, such as bruising and abdominal pain. Patients may find blood in their urine after undergoing ESWL. ESWL can often be done on an outpatient basis, but more than one appointment may be needed to eliminate all of the kidney stone or stones.

Percutaneous Nephrolithotomy

• If a kidney stone is large or if sound waves can't reach it, a surgeon can perform percutaneous nephrolithotomy to remove the stone. The surgeon makes a small incision in the back and, using an instrument called a nephroscope, enters the kidney and takes out the stone. Some stones may need to be broken into smaller pieces with ultrasonic or electrohydraulic energy, then removed. After percutaneous nephrolithotomy, patients must stay in the hospital for a few days, but the procedure does have one special advantage: since the surgeon takes all the kidney stones out, the patient doesn't have to undergo the process of urinating out the pieces.

Ureteroscopic Stone Removal

• Sometimes kidney stones get stuck in the ureter (the tube leading from the kidney to the bladder). In which case, ureteroscopic stone removal might be necessary. The process doesn't require an incision. Instead, the surgeon threads a ureteroscope through the urethra and bladder and up into the ureter itself. There, the surgeon can either pull out the kidney stone or use ultrasonic or electrohydraulic energy to break the stone into passable pieces.