Kidney Stone Removal

 

 

There are many methods that are adopted for kidney stone removal. Kidney stones are formed by the aggregation of tiny crystals that are created by substances that accumulate in the kidney.

Severe flank pain that radiates to the back is the most common symptom of the presence of kidney stones and dehydration is the major risk factor for the formation of stones.

The other signs of kidney stones include presence of blood in your urine, fever, chills, the cloudy appearance of the urine and a burning sensation at the time of urination.

If your kidney stones are small enough and severe symptoms are not present, the doctor will ask you to drink 2 -3 quarts of water every day and take over-the-counter pain relievers such as ibuprofen, naproxen sodium and acetaminophen.

Most small kidney stones go out with the urine and you may not require any treatment.  Some methods of treatment for kidney stones are discussed below.

 

 


 

 

 

How Lithotripsy Works

 

 

 

 

JUST THE FACTS
 TREATMENT Extracorporeal Shock Wave Lithotripsy   (ESWL)
PROCEDURE Non-invasive treatment – Shock waves break  up the stone into sand particles that  flush out of your system during urination.
  SIDE EFFECTS
Blood in urine – Abdominal discomfort
 RECOVERY  1 – 2 Days
 COSTS  $5,000 – $7,000+      Prices vary

 

 

Analysis

This method involves splitting your kidney stone into tiny pieces by focusing shock waves on to the stone through water. The tiny pieces pass out of your body through the urine.

Extracorporeal Shock Wave Lithotripsy is suitable if you have just one stone and the size of the stone is not more than 3 centimeters.

You can expect a success rate of 90% when the size of the stone is less than 1 centimeter and is located in the pelvic portion of the kidney.

 

Extracorporeal Shock Wave Lithotripsy

Typically, success rate is decided by the size of your stone and the extent to which it can be crushed.

This treatment method is suitable if you cannot tolerate a surgery or you have health conditions like hypertension, heart disease, diabetes, etc.

If all the stone fragments do not pass off through your urine and some remain in the urinary tract, the possibility of formation of new stones is very high.

Depending on the type of your kidney stone, the effectiveness of this treatment method will vary.

Some types of calcium stones and uric acid stones can be easily crushed and eliminated through urination.  Other types of calcium stones are difficult to crush and the success rate in such cases is only around 40%.

In the case of cystine stone, small ones break up easily, but larger stones are difficult to fragment.

The side effects of Extracorporeal Shock Wave Lithotripsy treatment include blood in the urine and abdominal discomfort for several days.  You will also experience pain when the pieces of stones rub against the walls of the urinary tract on their way out of the body.

However, you will be back to normal in a short period of time. The cost of carrying out this treatment is around $5,000 – $7,000.

 

 

 

Ureteroscopy

 

 

 

 

JUST THE FACTS
 TREATMENT Ureteroscopy
PROCEDURE The surgeon inserts a small fiber optic instrument called a ureteroscope up through the urethra into the bladder then  into the ureter where the stone is located and removed using a basket tool or blasted into smaller particles with a fiber laser.
SIDE EFFECTS
Potential for ureter damage, blood in urine, pain, burning sensation in the urethra and urinary infection may occur
 RECOVERY  1 – 2 Days
 COSTS  $5,000* +   Prices vary

 

 

 

Analysis

In this method, a small fiber optic instrument called ureterscope is passed through your urethra and bladder into the ureter. The surgeon locates the stone and removes it using a tool or crushes it by using shock waves.

He may also leave a small stent in the ureter for a few days after treatment to enable healing of the lining of the ureter. This procedure is done under general anesthesia.

 

Ureteroscopy

This is an effective technique if the kidney stone is located in the middle or lower part of the ureter.

The risk of damage to the ureters is high in this method.

You may experience pain, discomfort, urinary leakage and infection if the ureter is accidentally perforated.

However, reports indicate that up to 95% of the patients who undergo ureteroscopy become stone free with very few complications.  You can return home 24 hours after the procedure.  

 

 

 

 

 

 

 

 

 

Laser Lithotripsy

 

 

 

 

 

JUST THE FACTS
 TREATMENT Laser Lithotripsy
PROCEDURE A surgeon inserts a ureteroscope into the urinary tract where he locates the kidney stone and blasts it into small pieces with a fiber laser.
SIDE EFFECTS
Nausea, urinary discomfort, blood in the urine
 RECOVERY  1 – 2 Days
 COSTS  $5,000*  +     Prices vary

 

 

Laser Lithotripsy

Analysis

In this treatment the urologist introduces a scope into your urinary tract to locate the stone.

The urologist then directs the laser on to the stone through the laser fiber using the working channel of the scope.

The stone is disintegrated and the pieces are washed off through the urinary tract.

You will be administered local or general anesthesia to carry out this minimally invasive surgery.

The advantages of Laser Lithotripsy over Extracorporeal Shock Wave Lithotripsy (ESWL) include:

•    Suitable for more complex stones.
•    With a single treatment higher success rates can be achieved.
•    For stone-free results only fewer sessions are required.
•    There is no risk of developing seeds for future stone formation.

In the early days of development of the technique, a stay in the hospital was required to conduct the procedure.  Currently, it is being done as an outpatient procedure.

Some of the side effects from surgery are nausea due to anesthesia and blood in the urine because of irritation.

You may have to shell out $5,000 to $7,000 for this procedure.

 

 

 

Percutaneous Nephrolithotomy

 

 

 

 

JUST THE FACTS
 TREATMENT Percutaneous Nephrolithotomy
PROCEDURE The surgeon makes a small puncture in your back where he guides a nephroscope to the kidney using small instruments to remove them through a tube.
SIDE EFFECTS
Bleeding, injury to blood vessels and infections
 RECOVERY  Up to 2 months
 COSTS  $11,000* +     Prices vary

 

 

 

Analysis

Percutaneous Nephrolithotomy refers to the surgical kidney stone removal procedure wherein a small puncture of about 1 centimeter is made on your flank to guide a special scope to the kidney.

The surgeon then inserts a small instrument to break the stone into small pieces and remove them. You will be administered general or spinal anesthesia prior to the procedure.

This technique can be used to remove stones that are more than 2 centimeters in size, specifically staghorn stones.

 

 

Percutaneous Nephrolithotomy

If your doctor recommends this procedure for you, 7 – 10 days of hospitalization may be required.

Pain killers may be given to you to control any discomfort.

It will take about 2 months to completely recover after the surgery, though light physical activities can be resumed after a month.

The major advantage of percutaneous nephrolithotomy is that the surgeon removes some of the fragments directly instead of relying on their natural passage through the urine.

Some of the risks of undergoing this surgery include bleeding as a result of injury to blood vessels within the kidney, infections, injury to the colon and renal blood vessels and urinary leak that may persist for some days.

This procedure costs you approximately around $11,000.

 

 

Open Kidney Stone Surgery

 

 
 

 

JUST THE FACTS
 TREATMENT Open Kidney Stone Surgery
PROCEDURE The kidney stone is manually removed by the surgeon using a surgical procedure that opens up the kidney
SIDE EFFECTS
Severe bleeding, infection and damage to the kidney.
 RECOVERY  4 – 6 weeks
 COSTS 12,000*  +     Prices vary

 

 

 

Open Kidney Stone Surgery

Analysis

This method involves opening of the affected area in the operation theater in a hospital after administering anesthesia and removing the stones.

The surgeon unlocks the pelvis of the kidney or the ureter through the incision made on the skin to manually remove the stone.

Since it is a surgical procedure, you will need four to six weeks time to completely recover.

 

The success rate of open surgery for staghorn stones is between 90 – 95%.

The risks associated with open surgery to remove kidney stones include severe bleeding, risks related to anesthesia, infection, possibility of hernia at the point of incision for the surgery.

The risk of damaging the kidney at the time of the surgery cannot also be ruled out.  

A part from these methods of kidney stone removal, many natural remedies for kidney stones are also available.

 

 

 

 Kidney Stone Removal -Resource
Wikipedia – Kidney Stone

Prevention
Management

 

 

 

 

 

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