Kidney stones are a painful medical condition in which mineral deposits form in the upper urinary tract. The upper urinary tract is composed of the kidneys and the ureters, the narrow tubes that drain urine from the kidneys into the bladder. The stones can be quite painful and serve as a focus of infection. There are many surgical techniques that are employed to treat kidney stones, each with its own risk of complications that should be considered by the patient.
Shock Wave Lithotripsy
Shock wave lithotripsy, or SWL, is the use of shock waves from a source external to the patient’s body to fragment the stone(s). Once the stone is broken into several fragments, they can be passed in the urine for resolution of symptoms. Complications include damage to kidney tissue from the shockwaves which can result in blood urine, damage to gastrointestinal structures from shockwaves, increased blood pressure and long-term reduction in kidney function. In addition, incomplete breakage of stones can occur which can necessitate repeat procedures, according to the textbook “Campbell-Walsh Urology.”
Percutaneous Nephrolithotomy
In percutaneous nephrolithotomy, or PNL, the surgeon makes a small incision in the patient’s back and inserts a hollow tube through which the stone is removed. The most significant risk is of hemorrhage, with up to 10 percent of procedures necessitating blood transfusion, according to “Campbell-Walsh Urology.” Other complications include infection, adjacent organ injury such as the bowel, and perforation of kidney structures.
Ureteroscopic Surgery
In this procedure, the surgeon uses small scopes to visualize the stones in the ureters. The surgeon can also use the scope to remove or destroy the stone. The overall rate of complications is 6 percent from this procedure, according to an August 2007 article in the journal Urologic Clinics of North America. Complications can include urinary retention after surgery, fever, pain and perforation of the ureters.
Open Stone Surgery
While minimally invasive options for kidney stone surgery exist, occasionally the surgeon has to “open” the patient up with a large incision to remove the stone. Often, patients with stones that don’t respond to other treatments will undergo this form of surgery. Complications include longer hospital stays and recovery period than with minimally invasive approaches, infection, diminished gastrointestinal function immediately after surgery, bleeding and urinary retention, according to “Campbell-Walsh Urology.”
About this Author
Saad Mohammad, M.D., is currently in the process of applying to residency anesthesiology. His first published research occurred in 2009 at the American Thoracic Society National Conference where a poster presentation was accepted and at the Bridgeport Symposium 2009. He began professionally writing in 2009 for Demand Studios as a freelance writer on issues in health and medicine.
