Indicators for Surgical Treatment
Some type of surgery may be needed to remove a kidney stone if the stone:
- does not pass after a reasonable period of time and causes constant pain,
- is too large to pass on its own,
- blocks the urine flow,
- causes ongoing urinary tract infection,
- damages the kidney tissue or causes constant bleeding, or
- has grown larger (as seen on follow up x-ray studies).
A number of surgical options exist that do not require major surgery.
Extracorporeal Shockwave Lithotripsy.
The most frequently used surgical procedure, ESWL uses shockwaves that are created outside of the body to travel through the skin and body tissues until the waves hit the dense stones. The stones become sand-like and are passed through the urinary tract in the urine.
Involves an incision in the back to creates a tunnel directly into the kidney. Using a nephroscope, the stone is located and removed. For large stones, some type of energy probe may be needed to break the stone into small pieces.
Ureteroscopic Stone Removal.
No incision is made in this procedure. A ureteroscope is passed through the urethra and bladder into the ureter. The stone is removed or shattered it with a shockwave.
1 Prevention and Treatment of Kidney Stones. NIH Consens Statement Online 1988 Mar 28-30;7(1):1-23.