Painless Kidney Stone Removal

This procedure is done to remove kidney stones. These are crystalized masses of salts inside a kidney .


1 hr : 30 min

08

2-3


The kidneys are a bean shaped organ. They are two in number.Its located in the back side of the lower abdomen. Its main function is to eliminate waste products and excess fluids from the body.

Urine is carried from the kidney to the urinary bladder (Organ that stores the urine) with help of tube like connection known as the ureter. Waste products include mainly salts like urea, sodium, potassium, etc.”

When the amount of water in urine decreases or the salts in urine increases, they tend to clump to become hard small masses known as stones or calculus. When such stones forms and stays either in the kidney or the ureters they are known as kidney stones. Stones that occur in the junction in between ureter and bladder is lower ureteric stone. The stone in urinary bladder is bladder stone.

Understanding painless kidney stone removal

The given procedures are done to remove the stone and save the kidney. By this the obstruction in the urinary flow is relieved.

This can be done by various methods depending on the size and location of the stone. That includes fragmenting the stones by laser, removing it with laparoscopic surgical techniques, etc.

How is painless kidney stone removal Performed

At first an Ultrasound or CT scan is done to identify the Location, size, position and number of stones. Smaller stones less than 5 millimeter in size can be flushed out through urine without surgical intervention. Drinking lots of water helps in passing out these stones.

Larger stones are broken down or removed using the procedures described below. Here there are two main procedures which is actually done depending on the size of stone present.

1. PCNL (Percutaneous Nephrolithotomy )-
A needle is sent through the patient’s lower back, right or left side, depending on the location of the stone. A guide wire is sent through the needle. The needle is then removed with the wire still inside. A device known as Nephroscope is inserted through the guide wire. This instrument finds the stone, and removes it.

PCNL procedure
URS

2. URS (Uretero Reno Scopy)-This procedure is usually preferred for stones smaller than 2cms, located in the lower part of the ureter. A minute camera is sent through the urethra to locate the kidney stone. The stones are then broken down into fragments with the help of laser which by heating the mineral, slowly breaks it down. The particles are then washed away with normal urine flow.

3.ESWL (Extracorporeal Shock Wave Lithotripsy)-  When a large stone is in the kidneys or in the upper ureters, we push it back into kidneys and attack it shock waves from outside. This is the process of stone breakage.

4.Laparoscopic Stone Removal- One can access the ureter and loop it. Make a small nick in the wall and take out the stone that is impacted there. Although it is rarely done, it is very useful in some situations.

Treatment window

The kidney stones should be removed within 6 weeks to 3 months. If not the obstruction would cause injury to the kidneys and might even lead to kidney failure. The surgery should be performed at an early stage to save the kidneys.

life after PAINLESS KIDNEY STONE REMOVAL

  • To drink plenty of fluids.
  • Take rest.

painless kidney stone removal FAQ

Kidney stones have occur because of deposition of calcium along with other phosphates, calcites , oxalates, etc. In the urinary tract.
It does that because you are probably excreting more calcium than other men (hypercalciurea) . it is also possible that the concentration of calcium in urine because you or not drinking enough amount of water or you might be getting dehydrated by sweating. In women it can also be because of urinary tract infections. Any combination of these factor might result in urinary stone.
The stone might pass from kidney to tube (the ureter). By blocking the ureter it might cause severe pain that begins in your loin(in your back) and spreads to the groin .this is one of the commonest presenting features of kidney stones. And often picked up in the emergency room.
Yes if the stones are not dealt with properly, the kidneys may become larger and larger (hydronephrosis) and eventually become a bag of urine being non functional.
Stones can cause blood in urine , they can move to the bladder where they can cause severe pain while the passage of urine and very rarely by obstructing the tube that leads the urinary bladder they can hold up both the kidneys (hydronephrosis) giving raise to failure of both kidneys.thus depending upon the degree of disease wide variety of symptoms can affect patients.
A simple ultrasound is enough show the stone and its distribution and how seriously they are blocking the tubes. Further investigation is best done with a CT scan which gives much more details on the size of the stone, whether it is blocking , where it is blocking and what is to be done.
Most of the times, in more than 90% of cases, everything settles down without any intervention by simply admitting the patient and dripping (IV fluid) and flushed out of the system. In a small percentage of cases, which do not settle down, where the stone is large , or is blocked we need to do some form of intervention.
Of course through the urinary tract itself , the bladder can be approached , and then from the bladder we can directly go up as direct vision with the help of cystouerthroscopy and URS up into the ureter. By series of manoeuvres the stones can be trolled out and then broken into small pieces

Urology Specialist

Dr. Ilamparuthi Chennakrishnan

GENITO- URINARY SURGEON
M.B.B.S., M.S. (General surgery), M.Ch. (Urology), D.N.B. (GUS), F.I.C.S.