Medical procedures for kidney stones can range from less-invasive methods such as shock waves to major open surgery. Usually kidney stones pass without medical intervention, but in some cases the stone is so large that no amount of consumed water will ease its passage down the urinary tract. If the stone is still growing, causing bleeding, or blocking the flow of urine leading to infection, medical attention is urgently needed. Yet major open surgery is only performed in less than two percent of cases. Eighty-five percent of kidney stones pass within two to three days with added water consumption, and the others can be treated with medications and less-invasive procedures to be eliminated. If you seek medical care for a kidney stone, your doctor will probably use X-rays or ultrasound to first determine the location of the stone and later to monitor the stone during treatment. Then a method of treatment will be decided upon depending on your individual situation.
Procedures available for kidney stones include:
- Extracorporeal shock wave lithotripsy (ESWL) uses shock waves or ultrasonic waves to break the stone down into tiny pieces to be passed out in your urine. It is usually used on kidney stones smaller than a half inch located in the kidneys or upper urinary tract. The procedure is not used for cystine stones or larger stones which are over an inch in size (three centimeters). The procedure is often done on an outpatient basis under anesthesia. You may be positioned in a water bath or on a soft cushion while ultrasound waves will generate shock waves to the stone. The shock waves shatter the stone into tiny pieces that will pass out of the urinary tract with urine. Sometimes a stent will be inserted into the ureter to help pass the fragments which can still cause discomfort.
- Percutaneous nephrolithotomy (PNL) removes the kidney stone in the upper urinary tract through a small incision in your back with an instrument called a nephroscope. If the stone is large or ESWL has not been effective, this surgical procedure is often used. Also, it is used for kidney transplant patients or when the kidneys are malformed. Cystine stones can be removed with this method because they tend to be drug resistant and do not respond to shock wave treatment.
- Ureteroscopic stone removal takes out stones lodged in the ureter and works well on stones in the lower part of that tube. A small instrument called an ureteroscope is inserted into the ureter through the bladder. Then ultrasound or laser energy can be directed through the scope to dissolve the stone.
- Parathyroid surgery involves removing one or more parathyroid glands which are located in your thyroid gland below your Adam’s apple. These glands can produce too much parathyroid hormone which causes your body’s calcium level to become too high. An excess of calcium secreted in your urine can lead to the formation of calcium stones. This condition often results from a small benign tumor on one of the thyroid’s four parathyroid glands. Advances in recent procedures for this surgery have reduced the amount of gland tissue removed, in order to leave more tissue which functions properly.
- Open surgery (nephrolithotomy) is performed by a surgeon when other methods have failed or are not appropriate, or when the patient is extremely obese. During the surgery, the kidneys are cooled with ice and X-rays will determine the location of the stone. The surgeon removes the stone and repairs any blockage in the affected area. Recuperation from the surgery can take from four to six weeks. (Placeholder2)
Removed kidney stones will be examined for their composition which can help identify the underlying causes. The complication rate for these procedures is low, usually in the one to three percent range, and kidney failure is extremely rare. It is important to make the lifestyle changes advised by your doctor to help stop the formation of kidney stones. If you have had complications in passing a kidney stone, you most likely will never want to experience again the pain and the medical procedures for kidney stones.
written by Joy Seeman
© H.I.C. HEALTH
Coe, M. F. (2007, October). Kidney Stones in Adults. Retrieved September 21, 2009, from National Kidney and Urologic Diseases Information Clearinghouse: http://kidney.niddk.nih.gov
Kidney Stones. (2008, January 31). Retrieved September 21, 2009, from Mayo Clinic.com: http://mayoclinic.com
Simon, M. H. (2009, July 27). Kidney Stones. Retrieved September 21, 2009, from About.com: http://adam.about.com