What Is a Laser Treatment for a Kidney Stone?

Kidney stones have caused man pain since ancient time. Benjamin Franklin is one of many historical figures whose battles with the condition are well-documented. Oh, if only Ben could see the laser treatment for kidney stones that are available today.

Decision

• Physicians utilize lasers in two of the three primary medical treatments for the removal of kidney stones. And the third, while it doesn't incorporate laser technology, sounds equally high tech as urologists direct shock waves into the fight against those painful kidney stones.

  The National Kidney Foundation reports that more than 90 percent of stones are allowed to pass on their own. Physicians prefer to let this natural process occur but, in extreme instances, a medical procedure may be necessary. This usually is the case when an infection has developed, blockage is occurring or when the stone is too large to pass through a very narrow area. If that becomes the case, then a laser treatment for kidney stone removal becomes paramount.

Ureteroscopy

• Also known as laser lithotripsy, this procedure utilizes a device called an ureteroscope, a long, wire-like object. It's used to look at the inside of the ureter, the bodily pathway that moves urine between the bladder and kidney. A urologist inserts the ureteroscope into the patient's urethra. The ureteroscope includes a tiny camera and light as well as an extra tube through which physicians can pass another small wire. It contains a fiber optic laser to smash the stone or a second wire with a small basket at the tip with which to remove the offending object. Performed under general anesthesia, the method requires one to three hours of procedure time with no hospital stay.

PCNL

• Percutaneous Nephrostolithotomy is commonly referred to as PCNL and is another laser treatment for kidney stones. It's the most invasive of the three techniques listed as it's the only procedure in common practice that requires an incision. A physician opens a small cut to the patient's back and moves under the skin with a tiny telescope (called a nephroscope) to the stone waiting in the kidney. The stone is then broken apart with a tiny laser beam so that the smaller particles may more easily pass through the urine stream. PCNL is a procedure primarily reserved for large or hard stones. Patients must receive general anesthesia, normally require a one or two day hospital stay and can expect a moderate amount of post-surgery pain.

ESWL

• This technique does not utilize laser technology but rather sends shock waves to do the job against kidney stones. The official name for this procedure is extracorporeal shock wave lithotripsy. Lithotripsy is a Greek word translating to "stone crushing." And that's what this process entails. A machine directs shock waves to the kidney stone with the intention of smashing it apart into smaller bits more easily passed through the urine stream. Older varieties of this machine have patients sitting in a tub of water. Newer machines enable the patient to simply lie on a table.

Considerations

• Urologists like Dr. Francis Lee, in his report "Update on the Management of Ureteric Stones," note some concern regarding the effect on fertility of those who undergo ESWL treatment. "(The) possibility of damage to unfertilized eggs and ovaries has been raised," he says. "While for men there is a significant deterioration in semen quality."