kidney stone removal surgeries

Are you worried about how to get rid of kidney stones after the failure of all possible home remedies? If so, this article is for you. Here, we have covered the top four surgical procedures that are being used in this modern era to remove and treat kidney stones.

Before knowing the best and safest kidney stone removal surgeries, learn exactly when you need to undergo the surgical intervention.

Kidney stones are formed when calcium, oxalate, and phosphorus levels in the urine are higher than the normal range. And, people who eat food items high in animal protein and contain too much salt or sugar are prone to developing kidney stones.

One can develop kidney stones of different shapes and sizes. So, based on the severity, complexity, shape, and size of kidney stones, Urologists or Nephrologists will recommend the best suitable surgical procedure.

If kidney stones are smaller, they tend not to cause pain or other symptoms and can pass out of the body in urine. So, they are called “Silent stones”. On the other hand, if kidney stones are large, they may not pass out of the body as silent stones do. So they are referred to as “Stubborn stones”. 

Almost 86% of stones tend to pass spontaneously within 30-40 days. But this duration is dependent on the size of the stone and its likelihood of passing spontaneously.

Size of the kidney stone

Approximate days to pass kidney stones out of the bodyThe success rate of passage
<2mm kidney stones8 days for mean passage 87% (may vary)
3 mm kidney stones12 days for mean passage76% (may vary)
4mm – 6mm kidney stones22 days for mean passage60% (may vary)
7 mm kidney stones35-55 days for mean passage48% (may vary)
8mm – 9mm kidney stones45-75 days for mean passage

25% (may vary)

For faster removal of kidney stones, one can opt for undergoing surgery. Here, we have listed the best four kidney stone removal surgeries that can help an individual to free from pain in the lower back or side of the body, blood in the urine, and severe pain while urinating because of kidney stones.

  • Percutaneous nephrolithotomy (PCNL)
  • Retrograde intrarenal surgery (RIRS)
  • Ureteroscopic lithotripsy or ureteroscopy removal of the stones (URSL)
  • Extracorporeal shock wave lithotripsy (ESWL)

You can refer to the table below to know when these surgical procedures are recommended to remove kidney stones.

Location or size of kidney stonesType of treatment or surgical procedure recommended
<2mm kidney stonesHome remedies and medications
Kidney stones that are 4 mm (0.16 in.) and 2 cm (0.8 in.) in diameterExtracorporeal shock wave lithotripsy (ESWL)
8mm to 15mm or up to 2 cm kidney stonesRetrograde intrarenal surgery (RIRS)
>14 mm kidney stonesPercutaneous nephrolithotomy (PCNL)
stones in the ureter, especially for stones closest to the bladderUreteroscopic  removal of stones or ureteroscopic lithotripsy (URSL)

In case you are confused about choosing the right type of kidney stone removal surgery, consult our expert Urologist, who can recommend and perform the safest surgical procedure to remove all sorts of complications with no risk of infection and prevent recurrence of kidney stones.

Percutaneous Nephrolithotomy (PCNL):

PCNL is a surgical procedure that is highly recommended for individuals with kidney stones larger than 14mm. Before the start of the surgery, the patient is sedated using general anesthesia to make the surgery painless.

Once the patient falls asleep, a catheter is placed in the bladder. To maintain it in the palace, an inflated balloon is used. Through this, a second catheter is placed into the ureter. For a better view and to find the location of the kidney stones, a contrast dye is instilled through the 2nd catheter.

Now, the surgeon uses a nephroscope to safely access the kidney through the guidewire. Once the kidney is accessed, a grasper is used to remove small kidney stones. For large or stubborn kidney stones, surgeons use lasers to fragment them, and then the fragmented stones are extracted.

To make sure all the fragmented and small kidney stones are removed completely, the surgeon may perform a contrast study. In a few cases, a double J stent (DJ stent) may be placed to ensure that the ureter is well wide open to drain the urine. Most patients who undergo PCNL may take 5-10 days to get back to their daily activities.

To know more about PCNL surgery, you can book an appointment with our Kidney Specialists at an affordable cost.

Retrograde Intrarenal Surgery (RIRS):

Retrograde intrarenal surgery is one of the advanced kidney stone removal surgeries recommended to treat kidney stones ranging between 8mm to 15mm or up to 2 cm. This is a painless surgery as the patient is given general anesthesia.

Once the patient is sedated, a flexible endoscope is inserted into the natural urine passage and passed into the kidney’s collecting part. From there, the scope is moved up to the urinary tract system [retrograde movement]. Once the flexible endoscope reaches the target location, the surgeon can see the kidney stones.

Then, the surgeon uses a laser probe to crush or manipulate kidney stones. In the case of large stones, small forceps are used to grab the kidney stones. The broken or fragmented kidney stones are collected in the basket and removed. Patients may take at least a week to return to their daily activities.

Ureteroscopic Lithotripsy or Ureteroscopy Removal of the Stones (URSL):

This surgical removal of kidney stones is suggested for those individuals with stones in the ureter, especially for stones closest to the bladder. In this surgery, anesthesia is administered to the patient to make the surgery painless.

The surgeon passes fine scope into the urethra to locate the kidney stones. Then, the stones are crushed or broken into small pieces and removed. In a few cases where the stones are large, micro forceps are used to take them out. The patient can get back to daily activities within two days after the surgery.

Extracorporeal Shock Wave Lithotripsy (ESWL):

Extracorporeal shock wave lithotripsy is mostly used to treat kidney stones that are between 4 mm and 2 cm in diameter. Here are the steps on how ESWL is performed to treat kidney stones.

  • General anesthesia is given to the patient by an anesthesiologist.
  • High energy shock waves are transmitted through water and directed at the kidneys to break the stones into smaller pieces.
  • The small pieces of kidney stones can now pass easily through the urinary tract.

Once the procedure is done, the patient may take several weeks to pass all fragmented kidney stones. However, patients may need to undergo a revision or a second procedure in a few cases.

Comparison of Kidney Stone Removal Surgeries

ParametersPCNLRIRSURSLESWL
Time to complete1.5 to 2 hours1 to 2 hours45 to 90 minutes45 to 60 minutes
Recovery period [time taken to get back to normal routines]5-10 daysAt least a week2-5 days1-3 days
Success rate80% to 90%75% to 93%85% to 95%70% to 89%
Cost of the surgeryRs. 60,000 – Rs. 80,000 [approximately]Rs. 95,000 – Rs. 1,05,000 [approximately]Rs. 60,000 – Rs. 80,000 [approximately]Rs. 35,000 – Rs. 50,000 [approximately]

[Note: All the data mentioned in the table is for reference purposes only. This data can vary from one person to another based on several factors.]

To select the right one out of these four kidney stone removal surgeries, we recommend you consult an expert Urologist or Kidney Specialist. Also, discuss the benefits and cons of each of these surgeries with the doctor.

In any case, if you delay the treatment, you can suffer from-

  • Kidney infections
  • Improper function of kidney stones
  • Blockage in the ureter
  • Sepsis
  • Hydronephrosis (swelling of a kidney due to a build-up of urine)
  • Renal scarring

So, it is always advised not to delay the kidney stone treatment.

Conclusion:

Kidney stones come in different sizes and based on the size, the treatment varies from one person to another. For small kidney stones, lifestyle changes and home remedies are highly recommended rather than surgical intervention. And for stubborn kidney stones, surgery is the best way to get rid of them. Out of several methods, PCNL, ESWL, URSL, and RIRS are highly suggested by many Kidney Specialists to remove and treat a wide variety of kidney stones. 

In India, we are associated with several top hospitals and expert Urologists to diagnose and treat kidney stones at an affordable cost. In addition, we provide several benefits like a free cab facility and no-cost EMI options for all our patients to make their surgical experience seamless and hassle-free. To know more, call us.

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