Kidney Stone Surgery
At University of Utah ÐÇ¿Õ´«Ã½, our urologists are highly trained and experienced in a full range of surgical procedures for kidney stone removal, in addition to non-surgical care. We also have the capacity to get patients in quickly for surgery, which means shorter waiting times between your diagnosis and treatment.
Best Candidates for Surgery
After we evaluate you, we may recommend kidney stone surgery if you have a stone that:
- is too large to pass, becomes stuck in your ureter, or does not pass for another reason,
- causes too much pain,
- affects your kidney function, or
- leads to infection.
The type of surgery that we perform for you will depend on the nature and location of your stone, your health, and other factors. Throughout the process—from preparing you for surgery through your recovery—we will be there to provide you with the best care as quickly as possible.
How to Prepare for Kidney Stone Surgery
When we meet with you, we will give you specific instructions to prepare for your surgery. They may include the following.
- Stop smoking, if you smoke, well in advance of surgery.
- Stop taking certain medications that can make it hard for your blood to clot, such as blood thinners like Coumadin, Plavix, Xarellto, and the like.
- Do not eat or drink anything after midnight prior to your surgery.
- Make sure you have someone to drive you home after your procedure.
We may also place a stent in your ureter (tube between your bladder and kidney) up to a few weeks prior to your surgery. This stent, which is completely internal, allows your ureter to dilate or enlarge and makes stone removal easier. Stents may also relieve acute pain from a stone, enable any infection to drain, and allow antibiotic treatment before surgery.
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Types of Kidney Stone Surgery
There are several types of kidney stone surgery that are highly effective and range from non-invasive to minimally invasive. The most common procedures that we perform at University of Utah ÐÇ¿Õ´«Ã½ include:
- shock wave lithotripsy (SWL),
- ureteroscopy with laser lithotripsy, and
- percutaneous nephrolithotomy (PCNL).
Shock Wave Lithotripsy
Shock wave lithotripsy (SWL) is a procedure that uses ultrasound energy to break a kidney stone into smaller fragments that can pass through your urine easier.
We will perform external shock wave lithotripsy while you are under general anesthesia (asleep) for about 30 minutes. During that time, we will press an ultrasound head called a lithotripter against your skin. Then we will apply shock waves as we focus on your stone using ultrasound and X-rays. After a brief observation period, you will be able to go home that same day.
Ureteroscopy with Laser Lithotripsy
We will perform ureteroscopy with laser lithotripsy while you are under general anesthesia (asleep). Over the course of about one hour, we will:
- Pass a small ureteroscope (camera) through your urethra (tube that carries urine out of your body from the bladder), 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 (cut).*
- 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 (in most cases) 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.
Percutaneous Nephrolithotomy (PCNL)
Percutaneous nephrolithotomy is a minimally invasive procedure that we use to remove large stones from the kidney, which do not respond well to other procedures, or a large number of small stones in one kidney.
We perform percutaneous nephrolithotomy while you are under general anesthesia (asleep). The procedure takes about two to three hours to complete. During the procedure, we will:
- Pass a small scope (camera) through a half-inch incision in your back and into your kidney.
- Break up your stone with ultrasonic energy that we direct through the scope.
- Suction out the stone fragments.
- Place a temporary plastic stent or other tube to help your kidney drain and stop any bleeding (in many cases).
You will likely stay in the hospital for one to two days after percutaneous nephrolithotomy. During this time, we may order X-rays to see if any stone pieces remain.
Other Surgery
If these less invasive procedures fail, we may suggest other surgery types to remove stones. However, this is rarely necessary.
Kidney Stone Surgery Recovery
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 (Flomax) 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.
Recovery Time
Recovering from kidney stone surgery varies depending on the type of procedure you have and your unique situation. You will likely be able to resume normal activities within:
- Two to three days of having an external shock wave lithotripsy procedure or ureteroscopy and laser lithotripsy.
- One to two weeks after undergoing percutaneous nephrolithotomy.
However, some of your activities may be limited due to discomfort if you have a temporary stent in place after your surgery.
Post-Surgery Symptoms
After your surgery, you may experience the following symptoms:
- soreness and bruising where the lithotripter touched your skin, if you underwent external shock wave lithotripsy,
- discomfort and blood in your urine for a few days, especially if you have a ureteral stent in place,
- pain and nausea as remaining stone fragments pass through your urinary tract, and
- incision and surgical site pain, if your surgery required it.
Complications and Potential Risks
Generally, kidney stone surgery is very effective and symptoms during recovery are mild. However, complications can occur, as with any surgery. The complications that are specific to kidney stone surgery are rare and vary by procedure type.
Risks of Shock Wave Lithotripsy (SWL)
They can include but are not limited to:
- infection,
- bleeding in or around your kidney, and
- failure to break up your stones.
Risks of Ureteroscopy and Laser Lithotripsy
They can include but are not limited to:
- infection,
- failure to remove all stone fragments,
- ureteral stricture,
- ureteral injury,
- and needing to keep a stent in place for a prolonged period of time.
Risks of Percutaneous Nephrolithotomy (PCNL)
They can include but are not limited to:
- infection,
- blood loss, which may require a blood transfusion,
- failure to remove all stone fragments, and
- injury to a nearby organ.
Make an Appointment With Our Urologists
Please contact the University of Utah ÐÇ¿Õ´«Ã½ urology team at 801-213‑2700 if you would like to schedule an appointment. Wherever you are in your journey—whether you are starting to have symptoms, need a follow-up after seeing another provider, or want to prevent a reoccurrence—we are here to provide the quick care and expertise you need.
