What is the treatment for kidney stones?
Kidney stone treatment varies based on their size and location. Small stones may pass on their own with increased fluid intake and pain relievers. However, larger stones often necessitate medical intervention, including:
- Medications to relax the ureters and facilitate stone passage
- Extracorporeal shock wave lithotripsy (ESWL)
- Ureteroscopy
- Percutaneous nephrolithotomy (PCNL)
Types of Kidney stone removal Surgery
Kidney stones, hard deposits formed from minerals and salts within the kidneys, may require surgical intervention when they become too large to pass naturally. Various kidney stone surgery types exist, each with its own advantages and applications:[1]
Non-invasive procedure that utilises sound waves to break down smaller stones into minute fragments that can be easily passed through the urinary tract. Commonly employed for kidney stones under 2 cm in the kidney or upper ureter.[7] In this procedure a thin, flexible scope is inserted via the urethra and bladder to locate the stone. The surgeon then employs a laser to break up the stone or extracts it using small instruments.[3] Effective for stones situated in the middle or lower ureter.[2] It is indicated for larger stones (exceeding 2 cm) or those resistant to other treatments. A small incision is made in the back to directly access the kidney and remove the stone.[4] Requires general anaesthesia and typically takes 3-4 hours. Recovery period ranges from 2-4 weeks.[8] Traditional open surgery may be required in rare instances for exceptionally large or complex stones. And it involves creating a larger incision to directly access and remove the stone.Shock Wave Lithotripsy (SWL)
Ureteroscopy
Percutaneous Nephrolithotomy (PCNL)
Open Surgery
The choice of kidney stone removal surgery depends on various factors, including the size, location, and composition of the stone. Your doctor will discuss the available options with you and recommend the most appropriate procedure for your specific case.
What is the best surgery to remove kidney stones?
The best surgery depends on the size, location, and composition of the stone. Generally:
- Shock Wave Lithotripsy (SWL) is preferred for smaller stones (less than 2 cm) in the kidney or upper ureter
- Ureteroscopy is effective for stones in the middle or lower ureter
- Percutaneous Nephrolithotomy (PCNL) is recommended for larger stones (greater than 2 cm) or stones resistant to other treatments.
Your urologist will assess your individual case and recommend the most appropriate kidney stone removal surgery based on the size, location, and composition of the stone.
When Would You Need Kidney Stone Surgery?
Kidney stone surgery may be necessary under the following circumstances:
- The stone exceeds a certain size (typically larger than 6mm) and is unlikely to pass on its own.[6]
- You are experiencing severe pain or complications due to the stone.
- The stone is obstructing the flow of urine.
- There is a risk of kidney damage if the stone is not removed.
- Other kidney stone treatments have proven unsuccessful.
Kidney Stone Surgery Procedure in Delhi
The specific steps of kidney stone surgery will vary depending on the type of kidney stone treatment being performed, but generally involve the following:
- Anaesthesia administration: You'll receive anaesthesia to keep you comfortable during the surgical procedure. This is typically general anaesthesia, which means you'll be asleep for the surgery.[7]
- Accessing the stone: The surgeon will use specialised tools to reach the kidney stone. This may involve:
- Using a thin, flexible scope inserted through the urethra (for ureteroscopy)
- Making a small incision in your back to access the kidney directly (for percutaneous nephrolithotomy)
- Positioning you on a table with a water-filled cushion beneath you (for shock wave lithotripsy)
- Stone removal or fragmentation: Depending on the procedure, the surgeon will either:
- Remove the stone whole using small tools
- Break up the stone using lasers, ultrasonic energy, or shock waves
- Suction out stone fragments
- Stent placement: In many cases, the surgeon will place a temporary stent (a thin, flexible tube) in the ureter to help urine drain and prevent blockages as you heal.
- Closure: If any incisions were made, they will be closed with stitches.
The entire procedure typically takes about 1-3 hours to complete, depending on the complexity of the case and the type of surgery being performed. After the surgery, you'll be monitored in a recovery area as you wake up from anaesthesia. The medical team will ensure you're comfortable and provide instructions for your post-operative care.
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While kidney stone surgery is generally considered safe and effective, there are some potential risks and complications that patients should be aware of:
- Infection: Urinary tract infections (UTIs) are one of the most common complications after kidney stone surgery. Symptoms may include fever, frequent urination, and burning sensation when urinating.[8]
- Bleeding: Some bleeding is normal in the early stages after surgery, resulting in dark urine. However, excessive bleeding can occur and may require additional treatment.
- Damage to surrounding organs: In rare cases, nearby organs like the spleen, liver, bowel, lung, or diaphragm may be injured during the procedure, especially with more invasive techniques like percutaneous nephrolithotomy (PCNL).
- Urinary tract problems can include, Ureteral strictures (narrowing of the ureter), Blockage of urine flow from stone fragments, and Temporary difficulty urinating
- Stent-related discomfort: If a ureteral stent is placed during kidney stone surgery, it can cause mild back pain or bladder irritation.
- Failure to remove all stone fragments: Sometimes, not all stone pieces are successfully removed, which may require additional procedures.
- Pain: Some degree of pain or discomfort is common after kidney stone surgery, but severe pain should be reported to a doctor.
Kidney Stone Removal Surgery After Care
By following the aftercare guidelines given below and your doctor's specific instructions, you can promote proper healing and reduce the risk of complications or stone recurrence after kidney stone removal surgery. Always consult your healthcare provider if you have any concerns during your recovery.
Your doctor may recommend avoiding:[11] Recovery time varies based on the type of kidney stone surgery procedure:Foods to Avoid After Kidney Stone Surgery
How to relieve pain after kidney stone surgery?
Recovery time after kidney stone surgery
Dr. Gautam Banga
MBBS, MS - General Surgery, MCh - Urology Urologist, Andrologist, Urological Surgeon, Urologist & Andrologist
What to expect after kidney stone surgery in Delhi?
After the kidney stone surgery procedure, you may experience:
- Some pain or discomfort (managed with medication)
- Frequent urination, some blood in your urine for a few days.
Your doctor will provide specific instructions for post-operative kidney stone surgery care, which may include:
- Drinking plenty of water
- Taking prescribed medications
- Avoiding strenuous activities for a period
- Follow-up appointments to ensure proper healing
Conclusion
Kidney stone surgery can provide relief from painful symptoms and prevent complications. By understanding the different types of procedures, what to expect during recovery, and how to care for yourself afterward, you can better prepare for your treatment and improve your outcomes. Always follow your doctor's instructions and don't hesitate to ask questions about your care.
FAQs
No, laser treatment for kidney stones is performed under anaesthesia, so it is not painful during the procedure. If you are experiencing pain or discomfort after laser treatment, be sure to contact your doctor or visit the nearest SCI hospital for evaluation.
No, small kidney stones may pass on their own without intervention. However, if you are experiencing symptoms such as pain, fever, or urinary tract infection, it is important to see a doctor to determine if treatment is necessary. SCI hospitals specialise in the diagnosis and treatment of kidney stones and can provide you with the best possible care.
Generally, kidney stones larger than 6mm may require surgical intervention, such as laser treatment or other minimally invasive procedures. For larger or more complex stones, open surgery may be necessary. If you have a kidney stone that is causing you pain or discomfort, it is important to see a doctor at an SCI hospital to discuss your treatment options.
Most kidney stone surgery procedures take between 1-3 hours. However, the length of time may vary depending on the size and location of the stone, as well as the type of procedure being performed. Your doctor will be able to give you a more accurate estimate of the surgery time once they have evaluated your individual case.
Yes, some smaller kidney stones can be broken up without surgery using a procedure called lithotripsy. Lithotripsy uses sound waves to break up the stones into small pieces that can then be passed out in the urine. SCI hospitals are equipped with the latest lithotripsy technology and can provide you with this treatment option if it is appropriate for your situation.
Recovery time from kidney stone surgery varies depending on the type of procedure performed. For most minimally invasive procedures, such as laser treatment and lithotripsy, recovery time is typically a few days to a week. For open surgery, recovery time may be longer, up to several weeks. Your doctor will provide you with specific instructions on how to care for yourself during your recovery.
While all surgeries carry some risk, kidney stone surgery is generally considered safe when performed by experienced professionals. SCI hospitals have a team of experienced surgeons who are experts in kidney stone surgery. They will take all necessary precautions to ensure your safety during and after the procedure.
The kidney stone removal procedure itself is not painful because it is performed under anaesthesia. However, you may experience some discomfort during recovery, such as pain, burning, or urgency when urinating. Your doctor will prescribe pain medication to help you manage any discomfort.
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Dr. Gautam Banga is a highly respected and accomplished urologist with a strong background in reconstructive urology. His expertise in this field has earned him international recognition, and he has been invited to share his knowledge at national conferences in several countries. Dr. Banga's professional journey has been marked by several key milestones, including his graduation from a prestigious medical institution, where he earned a Master of Surgery (MS) in General Surgery. This foundation in general surgery laid the groundwork for his future specialisation in urology.
