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 Health 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.
