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How Do Doctors Remove Kidney Stones

Kidney Stone Surgery Recovery

This is how doctors remove kidney stones

Our urology experts will be there for you throughout your recovery to monitor your progress and ensure you are in good health.

We may prescribe medication like tamsulosin to relax and open your ureter for a period after surgery. Tamsulosin can make it easier for stones or stone fragments to pass. We may also have you use a strainer to collect stone pieces if they pass in your urine so we can test them.

If we placed a temporary stent in your ureter during surgery, we will remove it during an office visit two to 10 days after your procedure.

How Can I Tell If I Have A Kidney Stone

Routine screening for kidney stones common but not recommended for all people.

Kidney stones can be detected using imaging such as X-rays, ultrasound, CT scan, or MRI. The best imaging currently available for kidney stone detection is a CT scan.

If you have crystals in your urine, that does not mean that you have a kidney stone. Crystals in the urine are common. If you have crystals in your urine along with other symptoms of kidney stones, you should see a doctor for an exam and imaging.

Do Not Take Soft Drinks To Remove Kidney Stones:

Soft drinks containing phosphoric acid that can reduce the level of citrate in your urine, making the situation more complicated.

Note that water is the best beverage for kidney stones at all times, even if coffee and tea are considered safe.

Avoid caffeine as much as possible. According to some sources, caffeine is safe some other sources say that the quality of caffeines water reduction can lead to complications. To be safe, choose caffeinated beverages.

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Frequently Asked Questions About Shockwave Lithotripsy

Where are your SWL services available?

We offer SWL services at our Barnes-Jewish Hospital and Barnes-Jewish West County Hospital locations

Why should I choose SWL?

SWL is an outpatient procedure, and one of the preferred treatments for small- to medium-sized stones. It is considered a safe and effective procedure with an excellent track record. As it is an outpatient procedure, you will be home just a few hours after the procedure. Recovery is generally very rapid.

Does SWL have any limitations?

As with any technology, there are limitations. Certain types of stones are very hard and resistant to breakage with shockwaves. Other, less common stones are invisible on X-ray, which means that they cannot be targeted for treatment. Therefore, if you have a history of cystine, monohydrate or uric acid stones, SWL may not be the best treatment for you.

Also, very large stones or stones that have traveled into the lower part of the urinary tract may be better treated by other methods. There are also some patient factors, including other medical conditions, which may affect your suitability for SWL. For instance, patients who are on blood-thinning medications or who may be pregnant should not undergo SWL procedures.

Is SWL associated with any side effects?
How can I make an appointment to discuss SWL with a Washington University urologist?

Please call 362-8200 to schedule an appointment at any of our clinic locations.

How Successful Is Shock Wave Lithotripsy

Tiny stones cause boulder

ln those patients who are thought to be good candidates for this treatment, some 50-75% are found to be free of stones within three months of SWL treatment. The highest success rates seem to be in those patients with smaller stones .

After treatment, some patients may still have stone fragments that are too large to be passed. These can be treated again if necessary with shock waves or with another treatment.

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What Other Treatment Choices Are Available

About 90 percent of stones pass through the urinary system without treatment. In cases where this does not occur, treatment to remove stones may be needed. Some stones may be dissolved by medicines. In other cases, one of the following methods of stone removal may be needed:

Percutaneous Stone RemovalWhen stones are quite large or in a location that does not allow effective lithotripsy, a technique called percutaneous stone removal may be used. In this method, the surgeon makes a small incision in the back and creates a tunnel directly into the kidney. A tube is inserted and the stone is removed through this tube.

Ureteroscopic Stone RemovalFor stones found in the lower part of the urinary tract, the doctor may pass a ureteroscope up into the bladder and ureter. A basket-like device may be passed through the tube to grasp and withdraw the stone.

Frequently Asked Questions About Percutaneous Nephrolithotomy

Where are your PCNL services available?

We offer office consultation for PCNL at our Barnes-Jewish Hospital and Barnes-Jewish West County Hospital locations. However, all PCNL procedures are performed at our Barnes-Jewish Hospital campus near downtown St. Louis.

Why is PCNL performed only at your Barnes-Jewish Hospital location? If I see a Washington University urologist at another location, will he or she still perform my procedure? Will I be able to follow up at my original clinic location?

PCNL is a complex procedure that requires highly trained support personnel and specialized equipment to ensure excellent outcomes. Although we see patients at many clinic locations, our resources for PCNL are concentrated on the Barnes-Jewish Hospital campus.

Continuity of care is important to us. Therefore, although you may be seen at one of our other clinic locations, be assured that your urologist will personally perform the procedure at our Barnes-Jewish Hospital campus and will oversee your hospital stay. You may then follow up at your original clinic location.

Why should I choose PCNL?

The decision to perform PCNL is generally based upon stone size. For large, complex stones, PCNL is the standard of care.

Why shouldnt my large stone be treated with SWL or ureteroscopy?
Are there any limitations to PCNL?
Is PCNL associated with any side effects?
How can I make an appointment to discuss PCNL with a Washington University urologist?

Request an appointment using link below.

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Working With Patients To Prevent Kidney Stones

Our specialists believe in treating the root cause of any condition. After removal of the kidney stones, our specialists offer a comprehensive medical evaluation to help patients define the causes of their kidney stone formation in order to help prevent recurrences.

Prevention is an important aspect of treatment. For this reason, our specialists prioritize discussing dietary advice in order to help prevent the growth of or recurrence of kidney stones.

Where Do Kidney Stones Come From

How doctors remove kidney stones.

Kidney stones form develop when certain substances, such as calcium, oxalate, and uric acid, become concentrated enough to form crystals in your kidneys. The crystals grow larger into “stones.” About 80% to 85% of kidney stones are made of calcium. The rest are uric acid stones, which form in people with low urine pH levels.

After stones form in the kidneys, they can dislodge and pass down the ureter, blocking the flow of urine. The result is periods of severe pain, including flank pain , sometimes with blood in the urine, nausea, and vomiting. As the stones pass down the ureter toward the bladder, they may cause frequent urination, bladder pressure, or pain in the groin.

“If you experience any of these symptoms, see your primary care physician,” says Dr. Eisner. “He or she will likely perform a urinalysis and a renal ultrasound, abdominal x-ray, or CT scan to confirm kidney stones are the source of your pain and determine their size and number.”

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Kidney Stone Surgery And Removal Procedures

  • Kidney Stone Surgery and Removal Procedures
    • Posted on

    Kidney stones can be stubborn and painful. In many cases, patients rely on a urologist for help removing these painful obstructions. Kidney stones are hard deposits of minerals that form in the body and can cause blockage in the urinary tract. Urologists will decide how to treat the stone based on factors like its size, the patients health and the amount of pain its causing.

    One cutting-edge and noninvasive method for treating kidney stones is called shock wave lithotripsy. Board-certified urologist Dr. Brian D. Hale describes it as using water waves to break up the stone. A machine is put against the patients body and creates small explosions. The water waves from the explosions target the stone. As many as 2,500 water waves are directed at the stone during a single treatment.

    These waves break the stone into small pieces similar to sand. The patient will be able to pass these much smaller pieces with greater ease. The whole treatment takes about 25 minutes. The procedure is mostly pain free but does require the patient to go under general anesthesia. In the early 2000s, patients were not required to go under anesthesia for this procedure. However, it was found that natural movements from the patient made it difficult to concentrate the water waves on the stone, so putting patients under anesthesia is now the general practice.

    Percutaneous Nephrolithotomy And Nephrolithotripsy

    A doctor may recommend these surgeries for people with large or irregularly shaped kidney stones.

    Both surgeries begin after a person receives general anesthetic. To access the kidney, a surgeon makes a small incision in the back and inserts a nephroscope, which is a small fiber-optic camera.

    If the surgeon removes the kidney stone through a tube, they are performing a nephrolithotomy procedure.

    A nephrolithotripsy procedure, on the other hand, involves breaking down the kidney stones with sound waves and removing the fragments with a suction device.

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    Ureteroscopy With Laser Lithotripsy

    We will perform ureteroscopy with laser lithotripsy while you are under general anesthesia . Over the course of about one hour, we will:

  • Pass a small ureteroscope through your urethra , into your bladder, and up to your stone, either in your ureter or kidney. The scope lets us see your stone without making an incision .*
  • Break your stone into smaller pieces using a small laser fiber, if needed.
  • Remove stone fragments with a small stone basket that we insert through the scope.
  • Place a temporary plastic stent inside the ureter to ensure that any swelling will not block stone fragments that are too small to be basketed or urine from draining. The stent is completely internal and does not require any external parts to collect urine.
  • After a brief observation period, you will be able to go home that same day.

    *Around five percent of the time, the ureter is too narrow for the ureteroscope. If this happens to you, we will leave a stent in place to dilate your ureter. We will reschedule your procedure for two to three weeks later.

    Take Steps To Bypass Kidney Stones

    KIDNEY STONE HOME REMEDY

    Even though kidney stones can be common and recur once youve had them, there are simple ways to help prevent them. Here are some strategies that can help:

    1. Drink enough water. A 2015 meta-analysis from the National Kidney Foundation found that people who produced 2 to 2.5 liters of urine daily were 50% less likely to develop kidney stones than those who produced less. It takes about 8 to 10 8-ounce glasses of water daily to produce that amount.

    2. Skip high-oxalate foods. Such foods, which include spinach, beets, and almonds, obviously raise oxalate levels in the body. However, moderate amounts of low-oxalate foods, such as chocolate and berries, are okay.

    3. Enjoy some lemons. Citrate, a salt in citric acid, binds to calcium and helps block stone formation. “Studies have shown that drinking ½ cup of lemon juice concentrate diluted in water each day, or the juice of two lemons, can increase urine citrate and likely reduce kidney stone risk,” says Dr. Eisner.

    4. Watch the sodium. A high-sodium diet can trigger kidney stones because it increases the amount of calcium in your urine. Federal guidelines suggest limiting total daily sodium intake to 2,300 milligrams . If sodium has contributed to kidney stones in the past, try to reduce your daily sodium to 1,500 mg.

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    Things That Can Help You Take A Pass On Kidney Stones

    If youve ever passed a kidney stone, you probably would not wish it on your worst enemy, and youll do anything to avoid it again. “Kidney stones are more common in men than in women, and in about half of people who have had one, kidney stones strike again within 10 to 15 years without preventive measures,” says Dr. Brian Eisner, co-director of the Kidney Stone Program at Harvard-affiliated Massachusetts General Hospital.

    Keeping Kidney Stone Pain Under Control

    If you are experiencing the intense discomfort of kidney stones , pain control is a top priority. A 2018 analysis of multiple randomized trials looked at different pain relief medicines given to people treated in the emergency department for acute renal colic. It compared nonsteroidal anti-inflammatory drugs with paracetamol or opioids. The study found NSAIDs offered effective pain relief with fewer side effects than paracetamol or opioids. NSAIDs directly inhibit the synthesis of prostaglandins, which decreases activation of pain receptors and reduces renal blood flow and ureteral contractions.

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    How Successful Are These Treatments

    In short dubious at best. There have been many reports of people using these natural methods, but the efficacy is unsubstantiated. Some people report success, but none of these treatments are based in scientific fact. For every anecdotal success story posted online, there are hundreds more stories of failures . So, what natural remedies DO work?

    4. Lab Grade Chanca Piedra

    Lab grade chanca piedra has shown high rates of success in kidney stone treatment. This herbal remedy breaks down and prevents the development of new kidney stones. The clinical benefits of all-natural Chanca Piedra are related to ureteral relaxation and to a putative reduction of the excretion of urinary crystallization promoters such as calcium. It first grabbed the attention of the scientific community in a 2002 study on rodents which demonstrated it slowed or halted kidney stone growth. Further studies indicated lab grade Chanca Piedra actually interferes with the process that would normally cause stones to form.

    Professor Dr. Nestor Schor speaking about his research on lab grade Chanca Piedra:

    Treatment with Phyllanthus niruri strongly inhibited the growth of the stones and reduced the number of stones

    These results show that Phyllanthus niruri has an inhibitory effect on crystal growth

    Percutaneous Nephrolithotomy Or Percutaneous Nephrolithotripsy

    Doctors remove 420 kidney stones from patient

    If your stone is large or lithotripsy doesn’t break it up enough, this surgery is an option. PCNL uses a small tube to reach the stone and break it up with high-frequency sound waves.

    You will be given something so that you wonât be awake during this surgery. Your surgeon will make a small cut in your back or side and place a thin scope into the hole.

    The surgery can be done in one of two ways:

    Nephrolithotomy: Your surgeon removes the stone through a tube

    Nephrolithotripsy: Your surgeon uses sound waves or a laser to break up the stone and then vacuums up the pieces with a suction machine.

    The surgery takes 20 to 45 minutes. You’ll typically have to stay in the hospital for a day or two afterward. Usually, a stent will have to stay in your kidney for a few days to help urine drain.

    Your doctor might do an X-ray or ultrasound a few weeks later to see whether any parts of the stone are left. They might also send the stone fragments to a lab to find out what they’re made of.

    Risks from this surgery include:

    • Infection
    • Damage to the bladder, bowel, ureter, kidney, or liver

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    Ureteroscopy And Laser Lithotripsy

    Along with SWL, ureteroscopy is a preferred method for the treatment of small-to-medium sized kidney stones located in any part of the urinary tract. Washington University was one of the first centers in the world to offer ureteroscopic stone treatment. Our highly skilled endourologists are available to offer advanced ureteroscopic stone management.

    Ureteroscopy and laser lithotripsy are typically performed as a same-day procedure with the patient under general anesthesia. During the procedure, the urologist passes a small scope through the urinary opening into the bladder and from there up into the ureter, the small tube that drains urine from the kidney to the bladder. Once the stones are located, they are targeted with a laser that breaks the stone into smaller pieces, which are then extracted, or into tiny pieces of dust that wash out of the kidney with normal urine flow.

    Often, a small tube, called a stent, will be placed temporarily to help the kidney drain after the operation. The stent is completely internal, and is generally removed after 3-10 days. Removal is performed quickly and easily in the office without the need for anesthesia.

    Although slightly more invasive than SWL, ureteroscopy may be the preferred option if you have certain types of hard stones that dont respond to SWL, or a stone that is not visible on X-ray. In addition, ureteroscopy is often preferable to SWL for stones that are low in the urinary tract, in the region approaching the bladder.

    Stent Removal After Kidney Stone Surgery

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    Try Shock Wave Lithotripsy To Remove Kidney Stones:

    Extracorporeal Shock Wave Lithotripsy is used to treat large kidney stones from 80 to 90 mm, as long as the stones are not in the lower third part of your ureter.

    With Extracorporeal Shock Wave Lithotripsy , the patient is placed under a machine called a lithotripter. This machine sends high-pressure sound waves to the patients body. These shock waves are capable of doing small pieces of large stones, which can later be extracted from the urine passage in general.

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