Stone surgery

Two operations are commonly performed to treat kidney stones.

1. Ureteroscopy involves passing a small flexible or semi-rigid scope through the water pipe and bladder up to the ureter and kidney to find the stone. When the stone is visualised using the scope it can then be broken with a laser. The stone can be broken to tiny fragments (the size of grains of sand) which then pass out in the urine, larger fragments can be removed with a tiny basket. Small and medium sized stones (up to 2cm) can be treated with ureteroscopy and laser. Larger stones may need to be treated with a PCNL.

2. PCNL (per-cutaneous nephrolithotomy) is a key hole operation through the back. A small incision is made in the back and a needle placed into the kidney. The needle hole is then stretched up to allow a telescope to be passed directly into the kidney. Using this technique larger (over 2cm) stones can be removed from the kidney. 

Stones can also be treated with Lithotripsy where shock waves are used to break up the stone. This does not require an anaesthetic; shock waves are passed through the back, and focused on the kidney stone to break them up. A few treatments are usually needed to completely break up the stone.

Stents

Depending on the operation and the position and size of the stones some patients may need a temporary ureteric stent inserted either before or after their operation. This is a thin, internal plastic tube that runs from the kidney to the bladder in order to allow the kidney to drain safely. These can cause discomfort and urinary symptoms so these are used for as short a time as possible. 

For more information on ureteroscopy, PCNL and ureteric stents see the BAUS website.