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Kidney stones are formed when certain substances present in the urine such as oxalate, calcium and uric acid start to crystallize inside the body. These salts and minerals form crystals that join together to form a kidney stone. These stones are usually created inside the kidney at the place where urine is collected before it flows to the ureter.
Small kidney stones often pass out with the urine and go unnoticed. But larger stones stretch and irritate the ureter when moving towards the bladder. Sometimes, they even block the urine flow and lead to excruciating pain. In most cases, kidney stones are 4 mm to 0.2 inches in diameter and are unable to pass out with the urine. Due to this, surgery is often performed to treat the condition. Urologists make use of a variety of surgical methods for breaking up, bypassing and removing kidney stones.
Kidney Stones Surgical Treatment
Lithotripsy
This is considered to be one of the most efficient procedures for removing stones from the upper ureter or kidney. In Lithotrispy, a probe, instrument or machine is used for breaking the stone into miniscule particles that easily pass out from the body naturally. However, it cannot be used for patients that have very large stones in their kidney or are suffering from certain medical conditions. Lithotripsy is performed through a variety of different techniques.
Ultrasonic Lithotripsy: This technique involves the use of high-frequency sound waves that are delivered inside the ureter to break the stone through an electronic probe.
Electrohydraulic Lithotripsy (EHL): In this technique, a flexible probe is introduced into the ureter that uses shock waves produced by electricity to break the stone.
Extracorporeal Shockwave Lithotripsy: This technique makes use of extremely focused impulses focused and projected from outside to pulverize the kidney stones. After this procedure, the stone breaks down into sand-like particles and pass through the body with the patient’s urine.
Ureteroscopy
This surgical procedure is used for breaking up and removing the stones present inside the ureter. In this procedure, a special instrument similar to a thin and long telescope is inserted inside the urethra; it passes through the bladder and reaches the stone in the ureter. After locating the stone, it is either removed using a small basket-like structure introduced through the ureteroscope or broken into small particles using a laser. Once broken, the patient can pass them out through normal excretory practice. This procedure is performed on outpatient basis under regional or general anesthesia.
Percutaneous Nephrostolithotomy
This surgery is performed under intravenous sedation and local anesthesia. In this process, the kidney stones are percutaneously removed directly through the kidney. A guidewire and needle are used to enter the kidney and remove the stones through various catheters threaded over the guidewire.
This process is known to provide a better outcome for treating large and medium-sized stones in comparison to shockwave lithotripsy. However, this surgery requires hospitalization of the patient for about 2 weeks.
Open Surgery
Open surgery for the removal of kidney stones is performed under general anesthesia and involves making an incision in the patient’s back. The stone is then removed through the incision made in the kidney or ureter. This process also requires prolonged hospitalization and necessitates several weeks of recovery time.
