What are Kidney Stones?
Kidney stones are hard deposits that are made up of minerals like calcium or uric acid. While they start off small, they can grow larger as more minerals are deposited. Some kidney stones are relatively small and you can easily pass them without treatment. However, some stones are larger and they become stuck within the urinary tract. These stones need to be removed with surgery.
You may have to undergo a procedure to remove your stone if you have the following:
- A large stone over 5 mm
- Intractable pain
- The stone is causing blockage for a prolonged period
- You develop a urinary tract infection with fever – this is an emergency
It is important to understand that kidney stones can vary in composition, and this affects both the type of procedure recommended and the likelihood of recurrence. Stones may be composed of calcium oxalate, calcium phosphate, uric acid, struvite, or cystine. Identifying the stone type through urine analysis and imaging can help your urologist tailor the most effective treatment and provide guidance on prevention strategies.
Kidney Stone Removal Options
There are 3 basic procedures to remove kidney stones:
Ureteroscopy and Laser Lithotripsy
For stones less than 20 mm in size, the best treatment is ureteroscopy and laser lithotripsy. This procedure is performed at the hospital on an outpatient basis. You will most likely return home immediately after your procedure.
During the procedure, you will receive general or spinal anesthesia from a board – certified anesthesiologist. Dr. Lazare then inserts a small fiber-optic telescope into the ureter. He visualizes the stone and disintegrates it with a small laser fiber. The tiny fragments can then be removed with a basket. The risks are low and the success rate is about 85% -90 %.
Recovery from ureteroscopy is generally quick. Patients may experience mild discomfort, urinary frequency, or blood in the urine for a few days. Drinking plenty of water helps flush out remaining stone fragments. Straining the urine may also help collect small fragments for analysis, which can inform prevention strategies for future stones.
Extracorporeal Shock Wave Lithotripsy
Extracorporeal shock wave lithotripsy, or ESWL, is the least invasive means of treating stones in the kidney or in the upper ureter. It is appropriate for stones less than 20 mm. The patient lies on a table and shock waves are then focused upon the kidney stone. The lithotripter machine is outside the body and the procedure is completely non-invasive. The lithotripter effectively disintegrates the stone into small pieces. The patient must then pass all the stone fragments out of the urinary system via the urine.
The stone-free rate with ESWL is in the 50 % to 60% range. The procedure is low risk.
After ESWL, patients may notice bruising or mild soreness in the back or flank. It is common to see small blood clots or fragments in the urine, which usually resolve as the stone fragments pass. Drinking extra fluids is recommended to help flush the kidney and minimize the risk of residual fragments causing obstruction.
Percutaneous Nephrolithotomy
Percutaneous Nephrolithotomy or PNL is performed upon patients with stones larger than 20 mm. Patients usually stay in the hospital for about 3 days following this procedure. The procedure is performed under general anesthesia.
A small opening is made in the back over the kidney with a needle. Dr. Lazare dilates this opening and then he inserts a fiber-optic telescope into the kidney. Dr. Lazare visualizes the stone and breaks it into small pieces with a wand – like instrument that creates mechanical shock waves. The stone fragments are then removed with suction.
PNL is particularly effective for very large or complex stones, including staghorn calculi. Postoperative care involves monitoring for bleeding, infection, and ensuring proper kidney function. Patients are advised to stay well hydrated and may be prescribed medications to prevent future stone formation. Follow-up imaging is usually performed to confirm that all stone fragments have been successfully removed.
Video About Kidney Stones
Contact Us
If you are dealing with painful kidney stones and are interested in learning more about your treatment options, contact our Brooklyn, New York office today. Dr. Lazare is a board-certified urologist and accomplished surgeon who can help treat your stone and help eliminate your pain.
Early evaluation and timely treatment are essential to prevent complications such as urinary tract infections, kidney damage, or chronic pain. By understanding your treatment options and working closely with your urologist, you can achieve relief and take steps to reduce the risk of future kidney stones.