Tags

Article Image

Kidney Stone Removal: The procedure, risks, complications, preparations

  • Posted on- Jul 18, 2016
  • 545 Views
  • 2
Written by site author.

Kidney Stone Removal is a surgical procedure that involves the removal of kidney stones from one of the ureter tubes (the tubes that carry urine from the kidneys to the bladder), or from the kidney itself. This procedure is also known as Extracorporeal Shock Wave Lithotripsy, Percutaneous Nephrolithotomy (PCNL) or Ureterolithotomy (URS). A Kidney Stone Removal procedure is generally performed to restore proper urine flow, from within the ureter (urinary retention).

How is a kidney stone removal procedure performed?

The type of kidney stone removal procedure to be used depends upon factors, such as:

  • Location of the stone within the urinary tract
  • Size of the stone
  • Composition of the stone
  • Presence of other medical co-morbidities

The kidney stones may be removed through any one of the following methods:


Percutaneous Nephrolithotomy (PCNL) procedure

  • This procedure is performed for large stones located within the kidney itself
  • The surgery is done under general anaesthesia. The surgeon makes a skin incision on the flank region, overlying the kidney
  • A wire is introduced through this small incision into the kidney up to the ureter. By using instruments that stretch the surrounding tissue (called dilators) the surgeon creates a space (a “track”) around this wire
  • An instrument, called the nephroscope, is then introduced through this track. This helps the surgeon visualize the stones directly
  • The stones are then removed using special instruments. A large stone may be broken up, before it is removed
  • A tube is then left in place to drain fluid from the surgical site for a period of time and the incision closed

Ureteroscopy (URS) procedure

  • This procedure can be used for stones in the ureter (or even in the kidney) and is performed under general anaesthesia
  • An instrument, called the ureteroscope, is introduced through the urethra (the distant most portion of the urinary tract, through which urine is voided), guided up the bladder and the ureter
  • The stones are visualized directly and removed

Shock Wave Lithotripsy

  • This procedure is performed under sedation using a machine, called a lithotripter
  • The lithotripter produces ultrasound waves that are transmitted through the skin and body
  • These ultrasound waves break-up the stones into smaller pieces
  • Multiple sessions may be required with this procedure

Open surgery

  • A Nephrolithotomy (stone removal from the kidney) or Ureterolithotomy (stone removal from the ureter) may be performed using a large skin incision, to expose the kidney or ureter
  • The surgeon then enters the affected part of the kidney/ureter, to remove the stone

A urologist performs a kidney stone removal procedure. The length of the kidney stone removal procedure will depend on the type of chosen technique, for stone removal. It may last from anywhere between a few minutes to a few hours.

Preparations needed before a kidney stone removal procedure

  • The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are being currently taken
  • Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time, before the procedure is performed
  • Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
  • Normally local anaesthesia is not used however do inform the physician if you are allergic to any local anaesthetics, lidocaine, etc
  • Avoid application of any cosmetics, deodorant, or topical medicines on the area, prior to the procedure
  • It is advisable to quit smoking and the use of any nicotine based products, for a while, before the surgery
  • Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
  • The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
  • For persons suffering from diabetes, it is important that the blood sugar stays within the normal range if not their diabetologist may have to control blood sugar by recommending insulin or a combination of oral medicines

Diagnostic lab tests before a kidney stone removal procedure

Before a kidney stone removal procedure, the patient has to undergo certain tests, such as:

Risks and complications during kidney stone removal surgical procedure

The possible risks or complications that may arise during the kidney stone removal surgery are:
  • Excessive bleeding
  • Infection in the surgical would
  • Damage to adjacent tissues and organs
  • Anaesthetic complications

Risks and complications after kidney stone removal surgical procedure

The possible risks and complications that may arise after a kidney stone removal procedure are:
  • Excessive bleeding
  • Infection in the surgical wound
  • Urine leakage
  • Abnormal scarring at the site of the kidney stone, resulting in partial or complete obstruction

Post-operative care needed after a kidney stone removal surgical procedure

  • Slowly resume daily activities as soon as possible, which aids in a faster recovery
  • Use a heat pad or warm compress to relieve pain, due to the incision
  • Resume showering and keep the wound clean and dry. Avoid taking baths, until the surgical wound is completely healed. Gently wash the surgical wound with an unscented soap
  • Elevate legs while resting, to prevent the formation of blood clots and reduce the possibility of swelling
  • Complete the course of prescribed medication, as advised by your physician
  • Take stool softeners to prevent constipation
  • Take antibiotic medications to help combat or prevent infection, as advised by your physician
  • Avoid taking non-prescription medications, such as aspirin. However, individuals may take acetaminophen to relieve pain (under advise from the physician)
  • Avoid all activities that are physically strenuous, for about 6 weeks after the surgery
  • Resume driving only after 2 weeks of being discharged from the hospital, or when advised by your physician
  • Avoid sex, till a complete healing has taken place (under advise by the physician)
  • Individuals are advised to have to clear liquids immediately after surgery, until the gastrointestinal tract begins functioning properly. Then, individuals are advised to have a well-balanced diet, which can aid in a faster recovery
  • Also, increasing one’s fluid intake may prevent constipation and stress, during bowel movements and urination

Comments

user profile image
06-04-2017 03:36 AM

The most salient feature of kidney stone removal is that it helps the patient get rid of the stones that have been creating trouble for the system and are proving to be a hindrance in the flow.

user profile image
01-01-2017 07:56 PM

The information you shared is very useful. It comprises of all the things ranging from causes, symptoms to treatment.

Ask a Query