Kidney stones, or renal calculi, can form anywhere in the urinary tract, although they occur most frequently in the kidney itself. Stones can be composed of different elements and result in pain, obstruction and infection. Smaller stones can usually be passed without any medical intervention. However, if large stones are not removed, the backup of urine causes infection and kidney malfunction, and will lead to irreversible damage. Several different treatment options are available, varying from minimally invasive to open surgery.
Extracorporeal Shock Wave Lithotripsy (ESWL)
The first choice of treatment for large kidney stones that do not pass on their own is extracorporeal shock wave lithotripsy (ESWL). This minimally invasive procedure employs the use of ultrasonic waves that go through the skin and tissues to shatter the stone into tiny pieces. Obstruction is relieved, and the stone fragments flush out with urine. According to the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC), sometimes stones do not completely shatter with a one-time procedure, therefore ESWL may have to be repeated. Also the shattered pieces can cause a minor obstruction and discomfort while passing through the urinary tract. If this happens, a small tube-like device called a stent can be placed to help the fragments pass. Complications of ESWL include temporary blood in the urine, bruising and pain.
Percutaneous Nephrolithotomy (PNL)
In the event that ESWL proves unable or unsuccessful in fragmenting the kidney stone, an open surgical procedure may be required. In percutaneous nephrolithotomy, a surgeon makes an incision into the kidney from the back and uses an instrument called a nephroscope to break up the stone. This procedure allows the surgeon to remove every single piece. General anesthesia is necessary, and a hospital stay of several days is necessary after surgery. A small tube called a nephrostomy tube is usually placed in the kidney during the healing process. The Mayo Clinic physicians recommend PNL for people in professions where sudden pain attributed to passing of a stone can endanger others’ lives, such as mass transit workers.
Ureteroscopic Stone Removal
For stones located in the ureters, the tubes that carry urine from the kidneys to the bladder, a procedure called ureteroscopic stone removal can be performed. A ureteroscope is a small telescope inserted by your doctor up the urethra, through the bladder and into the ureter to examine and remove the stone. This device allows clear visualization with fiber optic lights and functions to break up, snare and remove a stone. U.S. News Health states that potential risks of this procedure include perforation of the ureter with scar tissue formation. The NKUDIC also say current use of this procedure is rare due to the high risk of ureter damage.
About this Author
Based in Chicago, Jojo Genden is passionate about sharing her health and wellness expertise through writing since 2008. She holds a Bachelor of Science in biology from Rockford College, and a Bachelor of Science in nursing from Edinboro University of Pennsylvania. Genden is a registered nurse in the state of Illinois with a background in intensive care.
