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Surgical Procedures for Kidney Stones
Surgery is an option when the stone is a size or shape that will prevent its passage and is blocking the flow of urine, or when it is causing damage to the kidney or another part of the urinary tract. Surgery may also be chosen if a kidney stone attack or serious kidney infection must be prevented (such as kidney transplant recipients). If the stone is very large, or in a spot that would be difficult to treat with extracorporeal shock wave lithotripsy (ESWL), your doctor may elect surgical removal of your kidney stones.
The kidney stone is removed through a small incision in the back.
Your doctor makes a small incision in your back through to your kidney. A tube called a nephroscope is then inserted. This tube is then used to remove the stone. A device called a lithotripter may be used to break the stone into smaller pieces for easier removal. After the stone is removed, a small tube called a nephrostomy tube may be placed in your kidney while it heals.
A flexible tube is snaked through the urethra and bladder into the ureter to retrieve the kidney stone.
A small, flexible fiberoptic tube is threaded from the urethra, into the bladder, and up into the ureter. A device passed through the tube is used to retrieve the stone. Sometimes the stone is broken up with a laser before it can be removed. A small plastic tube called a stent may be left in place to hold the ureter open as it heals. It is temporary and must be later removed. Your doctor will instruct you on how to watch out for infection.
In very rare instances, open surgery is required to remove a very large or oddly shaped stone that is obstructing the flow of urine from a kidney.
An open incision several inches long is made, usually in your flank, to access the kidney and remove the stone. Recovery time is longest with open surgery.
Mariappan P, Tolley DA. Endoscopic stone surgery: minimizing the risk of post-operative sepsis. Curr Opin Urol. 2005;15(2):101-105.
Nephrolithiasis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 22, 2013 . Accessed April 16, 2013.
- Reviewer: Adrienne Carmack, MD
- Review Date: 03/2016
- Update Date: 03/15/2015