Purpose Of Kidney Stone Surgery
The purpose of kidney stone surgery is to remove a stone in order to reduce symptoms and/or reverse a medical condition associated with the presence of the stone .
Specific indications for kidney stone surgery include:
- Ureteral stones greater than 10 mm
- Uncomplicated distal ureteral stones less than 10 mm that have not passed after four to six weeks of observation
- Symptomatic kidney stones without any other explanation for the patient’s pain
- Ureteral or kidney stones in pregnant women that have not passed after an observation period
- Persistent kidney obstruction related to stones
- Recurrent urinary tract infections linked to stones
Aside from the above indications, emergency surgery to remove a kidney stone may be warranted in the following cases:
- If the flow of urine from both kidneys is blocked and there is acute kidney injury
- If a patient has acute kidney injury from an obstructing stone and only one functioning kidney
- If a patient has an obstructing stone and a urinary tract infection
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:
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.
Recovery Instructions After Kidney Removal
Activity
- Take rest whenever you feel tired. Getting plenty of sleep may speed your recovery.
- Go to walk every day. Increase the distance you walk daily. Walking increases circulation of blood and prevents constipation and pneumonia.
- Dont do strenuous activities and exercises in which your belly muscles are used such as jogging, cycling, aerobic exercises or weight lifting until your physician recommends you to do them.
- For a period of at least four weeks, dont lift anything that causes straining of muscles such as lifting a child, milk containers, heavy bags of groceries, cat litter, vacuum cleaner or heavy backpack or briefcase etc.
- Place a pillow on the incisions while you take deep breaths or coughs to support your stomach and decrease pain.
- What is the recovery time for kidney removal? Discuss with your physician about the time you can resume driving.
- You may have to take four to six weeks off from your work.
- You may take showers however, if a drainage tube is put near the incisions avoid taking bath for the initial two weeks. Follow the instructions of your doctor to empty and take care of the drainage tube.
- Ask your physician when you can resume having sex.
Diet
Medicines
Incision Care
Follow-Up Care Forms a Vital Part of Treatment
Make sure to be regular with all appointment. Call your physician or nurse line in case of any problems. You can also keep a list of medications you take and know the results of your tests.
Monitor Your Kidney Function
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What Happens On Surgery Day
Your surgeon will give you specific instructions on what to do with your medications and diet before the date of your procedure. Most laser kidney stone treatments are done on an outpatient basis, so you can go home the same day.
You will have general anesthesia, so you will sleep through surgery. This helps make sure that you are still when the small instruments are inside your body. Newer lasers are precise and powerful which can make it easier for the surgeon to control and fragment the stone. This helps reduce the time of your surgery, so you can spend less time asleep and get back to your normal routine faster.
Pain After Kidney Stone Removal And Stent Symptoms:
Signs and symptoms after kidney stone removal and stent also depend upon the duration for which the stent is allowed to be present inside the kidneys.Signs and symptoms can therefore be differentiated into minor and major:
| Minor Symptoms |
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When the patient urinates, he/ she may feel slight tugging or stretching in the back especially at the end of urination.In persons who are skinny or overweight, the stent may get pushed over the adjacent nerves. Irritation of nerves can cause a burning-like pain or sensation in the back or thighs.
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Frequently Asked Questions About Percutaneous Nephrolithotomy
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.
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.
The decision to perform PCNL is generally based upon stone size. For large, complex stones, PCNL is the standard of care.
Request an appointment using link below.
What To Expect During Your Procedure
We want to keep you as comfortable as possible. Before your procedure, we give you anesthesia to put you to sleep so you dont feel anything. Dr. Buschemeyer proceeds with meticulous detail, inserting the ureteroscope into your ureter and bladder to examine any issues in your urinary tract.
If you have a small kidney stone, he uses a miniature wire basket to pull the stone out.
For a large stone, he might use a laser fiber that goes through the scope to break it apart. Once that happens, Dr. Buschemeyer can suction all of it out through your urinary tract. He performs the entire procedure without making any incisions.
It can take an hour or two depending on the size of your kidney stone.
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What Are The Advantages And Disadvantages Of This Treatment
The main advantage of this treatment is that it treats kidney stones without an incision. As a result, hospital stays and recovery time are reduced.
But, while SWL can work, it doesn’t always work. After SWL, about 5O% of people will be stone free within a month. In others, stone fragments of various sizes remain. Sometimes a repeat procedure is needed.
SWL has the potential to cause kidney injury. Whether or not SWL causes or leads to the development of high blood pressure and diabetes remains controversial. These possibilities are still being studied. You should ask your doctor about risks and benefits of SWL in your situation.
How Do I Prepare
You donât have to do a lot to get ready for a ureteroscopy. Youâll need to pee before the procedure. Your doctor or a nurse will tell you when.
You should also get instructions about how long before the surgery you need to stop eating, drinking and taking some medicines. This is very important if you take blood thinners to reduce your risk of blood clots.
You should also make sure someone can drive you home.
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What To Expect After Passing A Kidney Stone
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How Will I Feel After Surgery
You may still experience pain after laser surgery. If you have a stent between the kidney and ureter, most pain will likely come from the stent because it can rub on the kidney or bladder. It also can make you feel like you have to urinate, and it may cause some blood in the urine. Men may have pain in the penis or testicles as well.
Your doctor will prescribe medications after surgery. Generally, these may include an antibiotic to prevent infection, pain medication, and perhaps something to treat bladder spasms and burning with urination.
Drink plenty of water to lubricate the stent and encourage any small stones to move out of the kidney. You will likely feel a more frequent urge to urinate, so you may want to stay close to a bathroom.
You can resume normal activities the next day, or as soon as you feel comfortable. Skip high-intensity workouts until after your stent is removed. Some pain medications restrict activities like driving, so check the warnings on the label. Your doctor will have additional recommendations for you to follow.
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When Is Lithotripsy Used
Kidney stones are usually small enough to pass through the urinary tract along with urine. In some cases, the stones are too large to pass on their own. Lithotripsy is normally used when:
Stones are too large to pass Stones are blocking the flow of urine. Stones are causing bleeding or infection Pain medication isnt effective when trying to pass stones
Some stones may be too large to treat with shockwave lithotripsy. The size, shape, location, and the number of stones will all be evaluated to see if this procedure is appropriate.
Your doctor may advise alternate treatment if you are pregnant, weigh over 300 pounds, have a pacemaker, kidney cancer, kidney infection, or on medications for cardiac conditions.
What Are The Risks Of Ureteroscopy
The risks of ureteroscopy treatment include infection, bleeding and injury to the ureter. There is a one in 1000 risk of a major injury that could require an extensive surgery to repair. Your healthcare provider may need to use a stent and leave it in place for one to two weeks to help your kidney heal and drain. If you have a stent, an appointment will be made to have it removed.
Last reviewed by a Cleveland Clinic medical professional on 02/08/2021.
References
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How Does The Urinary System Work
The body takes nutrients from food and converts them to energy. After the body has taken the food that it needs, waste products are left behind in the bowel and in the blood.
The urinary system keeps chemicals, such as potassium and sodium, and water in balance, and removes a type of waste, called urea, from the blood. Urea is produced when foods containing protein, such as meat, poultry, and certain vegetables, are broken down in the body. Urea is carried in the bloodstream to the kidneys.
When To Seek Medical Attention
- Fever or chills
- Severe pain, which may be a sign of a blockage or other surgical complication
- Heavy bleeding or blood clots in your urine, which may be a sign of bleeding around the kidney
- Signs of a urinary tract infection like burning when you urinate or foul-smelling urine
- Signs of a wound infection like increased warmth/redness/swelling/tenderness around your incision site
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Stent Removal After Kidney Stone Laser
Similar to ureteral stones, kidney stones can be fragmented and removed with baskets. Occasionally, a kidney stone will fragment with a laser into very small. Jun 26, 2011 · In most patients, stent removal is a relief as their stent discomfort goes away. However, in some patients, severe pain may occur for several hours.
The stent is usually removed after a few days to a few weeks depending on the particular circumstances. Ureteric stents cannot stay in the body indefinitely (.
Following URS, clinicians may omit ureteral stenting in patients meeting all of the.
Index Patient 12: Adult, renal stone with pain and no obstruction.
The ureteral stent is typically removed in the office, usually within 1-2 weeks after the procedure but may be left for longer after complex procedures. If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: 646-663-4421. Dr. Alex Shteynshlyuger is a board certified urologist in NYC who.
If you have had a stent inserted after kidney stone surgery, it is temporary and only needed for a short period of time. There are two main methods for removal. For most patients, the stent will only stay in place for 5-7 days. Is a stent necessary after kidney stone removal? The routine placement of a ureteral catheter or stent following.
The stent removal does not hurt at all, I removed mine myself. The after effect of bladder spasms and kidney pain had me going back to the emergency room.
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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Recovery Immediately After Nephrectomy
After surgery, you will wake up in a recovery area. You will probably have a catheter to drain your urine it will likely be removed the next day. You also may have a nasal cannula placed under your nostrils to provide oxygen.
Your surgeon may have injected a long-lasting pain-relieving medication at the surgery area to alleviate pain and discomfort for at least the first day. If you do have pain, let your care team know they can manage your with additional pain relief medication. If you had a laparoscopic surgery , you will have several small incisions, typically in your abdomen or sometimes on your back. If you had traditional open surgery youll have a 3 to 4 inch incision on your side, which requires more wound recovery.
In the first hours after the surgery, your health team will have you up and walking around as soon as possible. Your goal is to walk every two hours to prevent in your legs. You also will be asked to do breathing exercises to expand your lungs and prevent pneumonia. And youll be encouraged to drink plenty of water to help avoid .
As you are recovering, your medical team will check your blood pressure and signs that your remaining kidney is working properly by checking your fluid balance and electrolytes. They also will watch for complications, such as infection, , bleeding severe enough to cause transfusion, blood clots and .
When Should You Call For Help
anytime you think you may need emergency care. For example, call if:
- You passed out .
- You have chest pain, are short of breath, or cough up blood.
or seek immediate medical care if:
- You have pain that does not get better after you take pain medicine.
- You have new or more blood clots in your urine.
- You cannot urinate.
- You have symptoms of a urinary tract infection. These may include:
- Pain or burning when you urinate.
- A frequent need to urinate without being able to pass much urine.
- Pain in the flank, which is just below the rib cage and above the waist on either side of the back.
- Blood in the urine.
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Preparing For Your Ureteroscopy
Before your procedure, we may perform an X-ray and lab tests. We also might ask you for a urine sample to make sure you dont have an infection. If we determine you have an issue, we ask you not to urinate for an hour before we begin your ureteroscopy.
To prepare you for your procedure, we apply monitoring devices on your body and give you an antibiotic to keep your body free of infection.
Is It Urgent That The Patient Be Treated With A Procedure Like This
lf the stone does not pass on its own, it will require treatment. lf you have an infection, severe pain, or if your kidney function is threatened, your doctors will act quickly. lf you only have one kidney or have had a kidney transplant, your stone will be treated more quickly. lf you have large stones or stones in both kidneys, your doctors will not wait to treat you.
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