What is the Best Procedure for Kidney Stone Removal?

Urologists treat kidney stones based on their type, size and location. Smaller kidney stones can pass on their own without treatment. Your urologist may advise you to drink plenty of fluids to help the stone move along your urinary tract. You will be able to pass smaller stones naturally without any treatment other than pain-relieving medication.

For kidney stones that are larger and block your urinary tract or cause unbearable pain, you may need treatment to break down and remove the stones. If you are vomiting and dehydrated, urgent treatment is necessary.

So what is the best procedure for kidney stone removal?

For larger stones causing excruciating pain or that may not pass on their own, surgery is typically the best treatment. There are four surgical procedures your urologist may consider: shockwave lithotripsy, ureteroscopy, percutaneous nephrolithotomy, and robot-assisted surgery. The best surgical procedure for your kidney stones will depend on their type and location.

You will need surgical kidney stone removal if:

  1. You have a lot of pain
  2. You have large stones that cannot pass on their own
  3. Your stones are blocking urine flow out of your kidneys
  4. You have recurrent urinary tract infections due to stones

At St Pete Urology, our urologists are highly trained and experienced in a full range of surgical procedures for removing kidney stones. We conduct minimally-invasive procedures which guarantee faster healing.

The procedure we perform on a patient will depend on the nature and location of the stone, the patient’s overall health, and other factors.

We ensure that you get the best possible care as quickly as possible, from surgery through recovery.

How are the surgical procedures performed?

1. Shock Wave Lithotripsy

Shock wave lithotripsy (SWL) is a procedure in which kidney stones are targeted using sound waves and X-rays. The stones are broken down before they are passed naturally in urine. This non-invasive procedure is used for small to medium-sized kidney stones, usually less than two centimeters in size, softer, and located in the ureter.

During the procedure, you lie on a table and receive medicine to limit pain and discomfort before high-energy shock waves are aimed at the stone from the outside. No cuts are made in your skin as the waves go through and break the stones into smaller pieces. Your urologist may insert a tube in your ureter, called a stent, which will aid in passing the stones. The procedure will take about an hour and you are free to go home the same day. Recovery time for shockwave lithotripsy is relatively short, so you will be able to return to normal activities within a few days.

2. Ureteroscopy

For bigger stones, your urologist may consider ureteroscopy. For this procedure, a small scope, called a ureteroscope, is inserted into the kidney via the bladder. When the stone is in the upper part of the ureter and kidney, your urologist will use a more flexible ureteroscope. If the stones are in the lower portion of the ureter near the bladder, a rigid scope may be used. Ureteroscopy is an outpatient procedure done without incision and under general or spinal anesthesia.

At St Pete Urology, one of the most common surgeries to treat kidney stones is ureteroscopy with Holmium laser lithotripsy. During this procedure, the urologist inserts a narrow, flexible ureteroscope through your urethral opening and passes it through the bladder to reach the stone. The stone is then collected from the location or broken up using a small laser fiber and removed.

3. Percutaneous nephrolithotomy

Percutaneous nephrolithotomy is a minimally-invasive procedure in which a surgeon makes a small incision, usually at the back or side to create a tunnel directly to the kidney to break and remove a large or irregularly shaped stone. Once an incision is made, an optical instrument, called a nephroscope, is inserted through the incision to reach the stone. The stone is broken down into small pieces and drawn out. This procedure is ideal for kidney stones that are big (larger than 2 centimeters), numerous, too dense, or located in a hard-to-reach area in the kidney or ureter. A stent is inserted to help with the excretion of urine as you heal from the surgery. You may need an overnight stay in the hospital after the procedure and can expect to recover in two to four weeks.

4. Robot-assisted stone removal

Kidney stones can also be removed using the da Vinci surgical system, particularly if you were born with a kidney drainage problem (ureteropelvic junction obstruction) or have complicated stones that cannot be removed successfully using other surgical methods.

This robotic surgical system gives urologists a high-resolution and three-dimensional view of small areas. It allows for an increased range of motion and the ability to make more precise incisions, which ensure less scarring. Patients who undergo this procedure recover more quickly and spend fewer days in the hospital, compared to those who have had traditional open surgery.

Why have your kidney stone removal at St Pete Urology?

At St Pete Urology, our urologists frequently treat patients with kidney stones of different types, locations and sizes. We perform hundreds of kidney stone surgeries every year, using mostly minimally invasive and robotic procedures.

Your condition will be managed by specialists who will recommend the best procedure, apply a personalized treatment plan, and deliver top-notch follow-up care. We will see you through your recovery period and monitor your progress to make sure you are in the best of health.

For more information on kidney stone prevention, diagnosis and treatment, visit the St Pete Urology website.