Despite the many benefits of surgery to remove kidney stones, it is not always the best choice. Many factors need to be considered before undergoing any surgery, from the size of the stones to where they are located. The following are the main reasons that a person might consider surgery for kidney stones. However, most people can pass out most small stones by themselves. Surgical removal of kidney stones is only recommended for larger, more complicated stones.
First, anesthesia must be given. The operation will take around 20 to 45 minutes. The stone must be removed from the kidney and the urinary tract. A ureteroscope is a narrow tube that is inserted through an incision made in the urethra. During the procedure, a laser beam is used to break up the stone. The surgeon will then remove the broken pieces. The stone may be removed, as well, depending on its size.
After surgery to remove kidney stones, patients may experience bleeding and a temporary urinary tract infection. They may also have a catheter in their bladder and a tube to drain urine. Blood in the urine is common after surgery, but the bleeding will subside in a few days. Patients may also be prescribed antibiotics and painkillers, and they should return to normal activities within four to six weeks. Symptoms of kidney stone surgery can last up to two weeks.
In addition to open surgery, patients can undergo ESWL. This noninvasive procedure is a safer and less traumatic alternative than traditional endoscopic retrograde cholangiopancreatography. It is also a better choice if a stone is larger than 2 cm in diameter. However, it may not be an option for patients who are pregnant or have other blood clotting problems. If an ESWL is unsuccessful, a different type of surgery may be necessary.
A flexible endoscope is inserted through the urethra into the urinary tract. Once inside the urinary tract, it travels up to the collecting portion of the kidney. A camera and light attached to the endoscope help surgeons view inside the body and where to find the stone. The stone may be removed entirely or require only a minimal ureteral stent. Typically, patients are discharged from the hospital the same day.
Percutaneous nephrolithotomy surgery is a minimally invasive procedure that is ideal for treating large or complex kidney stones. The procedure is performed with general anesthesia. A catheter is inserted into the bladder to drain urine, and a balloon keeps it in place. A surgeon may also insert a stent to help the body heal and avoid recurrent stone formation. Once the stones are removed, the procedure usually takes one to two hours.
A second procedure, known as extracorporeal shock wave lithotripsy, can be used to break up large stones. During the procedure, the patient is placed on a specialized table. A machine then sends shock waves to the affected area. The shock waves break the stone up into small pieces that will pass on their own or require surgery. The procedure takes about 45 minutes, and the patient is required to lie still for a short time afterwards.