Treatment Options: Invasive
Open surgical procedures are rarely performed on stones, physicians usually opt for a non or minimally invasive procedures such as, EWSL and PowerSuite™ holmium laser lithotripsy. There are, however, specific indications that often make open surgery necessary. These include:
- Failure of less invasive treatments due to size, composition and location of the stone
- Certain anatomic configurations of the urinary tract
Percutaneous Nephrolithotomy (PCNL), sometimes known as nephrolithotripsy is a surgical method that is often used on kidney stones larger than 2 centimeters in size or for hard stones. General anesthesia is required. A small incision is made in the back and a telescope (called nephroscope) is passed directly into the kidney. Direct fragmentation of the stone is performed using an ultrasonic, electrohydraulic, or laser device through the nephroscope under direct vision. The stone fragments are then removed through the tube.
Benefits and Risks
BenefitsPercutaneous nephrolithotomy successfully removes stones in the kidney about 95 times out of 100 and successfully removes stones in the ureter about 88 times out of 1001.
RisksRisks of this procedure include:
- Bleeding
- Holes (perforation) in the kidney (these usually heal without further treatment)
- Injury to surrounding organs
- Permanent damage that affects normal kidney function
After Care
With percutaneous lithotripsy (invasive-surgery) you will be in the hospital for at least 2 to 3 days. Most people are able to return to work within a few weeks. You may need to take antibiotics and anti-inflammatory medicines for a few days.
You will need to have someone drive you home from the hospital or clinic after your treatment. Your doctor will recommend resting for a time following your treatment before returning to normal activities.
Remember to drink plenty of water in the weeks after treatment (8-10 glasses a day), water will help pass any remaining pieces of stone and prevent them from coming back. You may have pain and nausea when/if any remaining pieces pass. You may experience the pain and nausea immediately after treatment and which may last for up to 4-8 weeks. Follow your doctors instructions for taking pain medication and drinking lots of water to help relieve these symptoms. It is normal to have a small amount of blood in your urine for a few days to weeks after the procedure.
You will be asked to visit your doctor for a follow-up appointment in the weeks following the surgery. (For example, this might include a kidney X-ray to determine if kidney stones are still present.)
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Non-Surgical
Non-Invasive
Minimumly-Invasive Holmium Laser Lithotripsy