Percutaneous Surgery


Kidney stones range in size, and they may become lodged in the kidney or urinary tract. Percutaneous surgery can provide relief.

Salts and minerals tend to accumulate and bind together in the body, especially when water is in short supply. This often leads to the formation of kidney stones. Both men and women are susceptible.

Kidney stones typically pass in urine on their own, but the process can be quite painful. Large, stubborn stones may require medical treatment to break them up for easier passage through the urinary tract. Percutaneous surgery is an option when other treatments are ineffective.


How Percutaneous Surgery Works

The urologist will order blood and urine tests before the procedure to check for infection or other issues. A CT scan, ultrasound, or X-ray imaging guide will pinpoint the location of the stone in the kidney.

The surgery can be approached in one of two ways. Nephrolithotomy is a procedure in which the stone is directly removed through a tube. In nephrolithotripsy, the stone is shattered by a laser or sound waves. The surgeon then uses a suction machine to vacuum up the fragments.

In either case, a small incision in the back provides access by means of a thin scope. Especially large stones may require more than one incision.

The surgeon may send the removed stone to a lab for analysis. This is to reveal the nature of the stone and check for possible infection.

Who is a Candidate?

Percutaneous surgery is usually a last resort when other treatments, such as ureteroscopy or extracorporeal shock wave lithotripsy, had poor results.

Surgery might also be recommended if the stone is larger than two centimeters in diameter, if the stone is lodged in your ureter, if the blockage threatens kidney function, if you are bleeding or have an infection, or if you are in intense, prolonged pain.

What to Expect

The procedure usually takes place with the patient under general anesthesia. Depending on where the stone is lodged, it typically takes 20 to 45 minutes. Antibiotics may be prescribed to ward off infection. Drainage tubes are sometimes left in the kidney. Some bleeding is to be expected. However, the presence of blood clots in your urine or the drainage tube should be considered an emergency.

During recovery, you should avoid lifting, pushing, or pulling heavy objects for a few weeks. Most patients return to work in about a week.

Urologists recommend a checkup four to six weeks after surgery. The visit might involve X-rays or an ultrasound to check for any remaining stones and ensure that your urine is draining properly from your kidney.

Your surgeon may have had your kidney stone analyzed. Depending on the makeup of the stone, ongoing treatment to prevent recurrence or simple dietary changes may be in order.