Removal of Kidney Stones with Percutaneous Nephrolithotomy or Nephrolithotripsy

Urologists are faced with removing a large variety of kidney stones. In many cases, these salt and mineral deposits harmlessly pass through the urinary tract and out of the body with no discernible symptoms. Because each patient is different, medical science has devised manifold treatment options for these deposits that may turn in to actual stones. In addition to shock wave therapy, other surgical treatments do exist. One such procedure is known as percutaneous nephrolithotomy or simply nephrolithotripsy.

In these types of procedures, the surgeon makes a small incision on the patient’s back to remove the kidney stones. A hollow tube is then inserted into the renal organ so a probe can pass through the tube. The surgeon is now in a position to break up the stones into smaller pieces and removes those fragments through the tube.

This type of surgical procedure requires the use of a general anesthesia or a localized spinal anesthesia while a drainage catheter will be needed in order to flush urine from the kidneys until the body is completely healed. During recovery, patients will need to stay in the hospital for two or three days and most people return to work within a week.

Medical science also recognizes that not all procedures will be appropriate for every patient. Therefore, the nephrolithotripsy procedure is best used on renal stones that present in the following ways:

  • Mineral deposits that grows to larger than two centimeters in diameter.
  • A condition known as staghorn calculi in which stones are rather large and caused by an infection.
  • Debris that blocks the flow of urine.
  • Stones that do not respond to extracorporeal shock wave lithotripsy (ESWL).

The success rate of percutaneous nephrolithotomy is quite high and the procedure successfully removes stones in the kidney approximately ninety-five percent of the time and successfully removes stones in the ureter about eighty-eight percent of the time.

As with any surgical procedure, even one that is as fairly straightforward as removing renal stones certain risks are inherent. Risks of a nephrolithotomy procedure include the following:

  • Profuse blood loss.
  • Perforations or holes in the kidney.
  • While these are cause for careful monitoring, they generally heal without further treatment or concern.
  • Injury to nearby or adjacent abdominal organs, such as the bladder or colon.
  • Other types of damage that may affect normal renal system function.
Mineral deposits that form into stones can also present complications, particularly if the stones move from the kidney into the ureter, a small tube that carried urine from the body. During a stone removal procedure, a stone that has lodged itself into the ureter will need to be pushed back into the kidney with a small tool called an ureteroscope; before the surgeon can break it up into smaller fragments.

These types of corrective procedures are used far more frequently than alternative procedures such as extracorporeal shock wave lithotripsy (ESWL) to remove larger stones, such as staghorn calculi. In these specific cases, every piece of a staghorn calculus must be removed to prevent the stone from actually re-growing and causing further problems.