One of the most popular kidney stone removal surgery procedures today probably shouldn’t be called surgery at all, because kidney stone removal is often now done without a doctor ever touching the stone or using a surgical instrument to remove it. The invasive techniques of three to four decades ago have largely been replaced, and those who suffer from kidney stones (and “suffer” is a good word for describing the pain) are much happier because of it.
But the reasons for kidney stone removal surgery remain the same. A kidney stone should be removed if it hasn’t passed through the urinary system on its own after a reasonable period of time. A “reasonable” period here would probably depend on the amount of pain the stone is causing. If the pain is constant and severe, the patient’s doctor will probably want to remove it as soon as possible. A stone should also be removed if it has grown to large to pass, is lodged in a difficult place, or is blocking urine flow. If the stone is causing an infection or some other kind of damage to the kidney or urinary tract, it should also be removed.
There are several ways doctors now use to remove kidney stones from the body.
The one that has gained the most popularity in recent years is called extracorporeal shock wave lithotripsy, or ESWL. This procedure employs a machine that produces a shock wave which travels harmlessly through the skin and internal organs, but breaks the stone into smaller pieces that are more likely to flow through the ureters and bladder in urine.
Several different kinds of ESWL devices are used. One emits shock waves as the patient sits in a pool of water. Other devices aim at a soft cushion that is placed next to the patient’s body. Anesthesia is necessary, but ESWL is generally done on an outpatient basis. When you have ESWL, you can resume normal activities pretty quickly – usually in a few days.
The downside to ESWL, which is often simply called lithotripsy, is that the stone is not always shattered during the first session. At least one follow-up session may be needed. ESWL may not also be suitable for certain types of stones, especially very large ones.
Percutaneous nephrolithotomy is another type of kidney stone removal surgery. This type is often used when the stone is too big to break up with ESWL. A percutaneous nephrolithotomy procedure can also be appropriate when the stone is located where ESWL won’t work very well. This type of operation requires the surgeon to make a small incision in the patient’s back, then insert a special instrument called a nephroscope to locate the stone and then take it out. This has an advantage over ESWL because the kidney stone is definitely removed, no fragments remain, and no follow-up procedures are needed. Patients who have had percutaneous nephrolithotomy are generally hospitalized for several days.
A third type of common surgery is known as a ureteroscopy. It is often an appropriate option for stones that are located in the mid to lower areas of the ureters. To perform this procedure, the surgeon uses a small fiberoptic instrument called a ureteroscope, which slides through the urethra and bladder into the ureter. Once the surgeon locates the stone, it can be removed with the same device. The surgeon alsohas the option to shatter the stone with a special instrument that creates a shock wave. No incision is needed.
Kidney stones rarely cause complications that are life-threatening, but the pain can be extremely severe and sometimes even debilitating. Anyone who has a kidney stone that’s causing such pain usually wants to get rid of it as soon as possible, and one of the kidney stone removal surgery procedures mentioned above offers options for doing it.