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Surgery is an option when the stone is a size or shape that will prevent its passage and is blocking the flow of urine, or when it is causing damage to the kidney or another part of the urinary tract. Surgery may also be chosen if a kidney stone attack or serious kidney infection must be prevented (such as kidney transplant recipients). If the stone is very large, or in a spot that would be difficult to treat with extracorporeal shock wave lithotripsy (ESWL) , your doctor may elect surgical removal of your kidney stones.

Percutaneous Nephrolithotomy

The kidney stone is removed through a small incision in the back.

Description of the Procedure:

Your doctor makes a small incision in your back through to your kidney. A tube called a nephroscope is then inserted. This tube is then used to remove the stone. A device called a lithotripter may be used to break the stone into smaller pieces for easier removal. After the stone is removed, a small tube called a nephrostomy tube may be placed in your kidney while it heals.

Ureteroscopy

A flexible tube is snaked through the urethra and bladder into the ureter to retrieve the kidney stone.

Description of the Procedure:

A small, flexible fiberoptic tube is threaded from the urethra, into the bladder, and up into the ureter. A device passed through the tube is used to retrieve the stone. Sometimes the stone is broken up with a laser before it can be removed. A small plastic tube called a stent may be left in place to hold the ureter open as it heals. It is temporary and must be later removed. Your doctor will instruct you on how to watch out for infection.

Open Surgery

In very rare instances, open surgery is required to remove a very large or oddly shaped stone that is obstructing the flow of urine from a kidney.

Description of the Procedure:

An open incision several inches long is made, usually in your flank, to access the kidney and remove the stone. Recovery time is longest with open surgery.

References:

Mariappan P, Tolley DA. Endoscopic stone surgery: minimizing the risk of post-operative sepsis. Curr Opin Urol . 2005;15:101-105.

National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www2.niddk.nih.gov .



Last reviewed October 2012 by Adrienne Carmack, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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