Treatment for kidney stones depends on the size of the stone(s), its location, the presence of a urinary infection, your medical profile, and the severity of the condition.
Urologists use several procedures to break up, remove, or bypass kidney stones.
Ureteroscopy – This procedure can be used to remove or fragment stones located anywhere from the kidney down to the bladder. A ureteroscope, which is a fiber optic instrument resembling a long, thin telescope, is inserted through the urethra and passed through the bladder to the stone. The ureteroscope has a camera that allows the Urologist to see the stone, and a working channel that tiny instruments pass through. Once the stone is located, the Urologist can break the stone up into dust sized pieces, using a laser or other fragmenting device. A Ureteroscopy is performed under general or spinal anesthesia on an outpatient basis.
Percutaneous Nephrostolithotomy (PCNL or tunnel surgery) – Percutaneous (through the skin) removal of kidney stones is accomplished by making a small cut through the skin on the patient’s back and creating a narrow tunnel through the kidney to the stone. With a special instrument that goes through the tunnel, the doctor finds the stone and removes it. This treatment can achieve the best stone-free outcome in the treatment of very large stones within the kidney. This procedure requires general anesthesia.
Shockwaves – Extra-corporeal shockwave lithotripsy (ESWL) has been used in the United States since 1984. It is performed using a machine called a lithotriptor.
Open or Laparoscipic Surgery – This procedure requires general anesthesia. An incision is made in the patient’s back or abdomen and the stone is removed by making an opening in the ureter or kidney, removing the stone and repairing the opening.