Introduction

Kidney stones are hard mineral and salt deposits that form inside the kidneys. While small stones can often pass through the urinary tract on their own, larger ones may require medical intervention—sometimes even surgery. Kidney stone removal surgery is a well-established treatment used to eliminate large, painful, or obstructive stones. This blog explains everything you need to know about kidney stone removal surgery, including types, procedure, causes, benefits, risks, recovery, and more.

What Are Kidney Stones?

Kidney stones (renal calculi) are solid, crystalline substances formed by minerals and salts in the urine. Common types include:

Calcium stones (most common)
Uric acid stones
Struvite stones
Cystine stones

These stones may vary in size, from as small as a grain of sand to as large as a golf ball.

When Is Kidney Stone Removal Surgery Needed?

Surgery may be required in the following cases:

The stone is too large to pass naturally.
The stone causes persistent pain, infection, or bleeding.
There’s urinary blockage or risk of kidney damage.
Other treatments, such as medications or lithotripsy, have failed.
The patient has recurrent stones or structural urinary abnormalities.

Causes of Kidney Stones

Kidney stones are caused by a variety of factors, including:

1. Dehydration :- Concentrated urine increases stone formation.

2. Diet :- High sodium, oxalate, or protein intake can contribute.

3. Obesity :- Increases the risk of stone formation.

4. Family history :- Genetic factors can play a role.

5. Medical conditions :- Hyperparathyroidism, urinary tract infections, and digestive diseases.

6. Certain medications :- Diuretics, antacids, and others can influence mineral levels.

Types of Kidney Stone Removal Surgeries

There are several types of surgical procedures used to remove kidney stones. The choice depends on the size, location, and type of stone.

1. Ureteroscopy (URS)

Procedure: A thin scope (ureteroscope) is passed through the urethra and bladder into the ureter or kidney.
Use: Best for medium-sized stones in the ureter or kidney.
Benefits: Minimally invasive, no incisions, shorter recovery.

2. Percutaneous Nephrolithotomy (PCNL)

Procedure: A small incision is made in the back, and instruments are inserted to break and remove stones directly from the kidney.
Use: Ideal for large or complex kidney stones.
Benefits: Effective for large stones, quick results.
Note: Requires hospitalization and anesthesia.

3. Extracorporeal Shock Wave Lithotripsy (ESWL)

Procedure: Uses sound waves to break the stone into smaller pieces, which pass naturally.
Use: Suitable for small to medium stones.
Benefits: Non-invasive, outpatient procedure.
Limitations: May require multiple sessions, not effective for all stone types.

4. Open or Laparoscopic Surgery

Procedure: Surgical incision to remove stones manually.
Use: Rarely used today unless other methods fail.
Benefits: Useful in complex or anatomical cases.
Drawback: Longer recovery and greater risk.

The Surgical Procedure: Step-by-Step

1. Anesthesia :- Depending on the procedure, general or spinal anesthesia is administered to ensure the patient doesn’t feel pain.

2. Accessing the Stone :-

For URS, the scope is inserted through the urinary tract.
For PCNL, a small incision is made in the back.
For ESWL, no incision is required.

3. Stone Removal or Breakdown :-

Stones may be manually extracted using forceps.
Laser or ultrasonic tools may break large stones into smaller fragments.
In ESWL, shock waves are externally applied.

4. Stent Placement (If Needed) :- A ureteral stent may be placed temporarily to ensure urine flow and help with healing.

5. Wound Closure :- In PCNL and open surgeries, the incision is closed with stitches or surgical glue. Other methods don’t require external closures.

Benefits of Kidney Stone Removal Surgery

1. Pain Relief :- Eliminating the stone immediately relieves severe, unmanageable pain.

2. Preventing Infection :- Infected stones can lead to sepsis. Surgery removes the source of infection.

3. Avoiding Kidney Damage :- Blocked kidneys can suffer permanent damage if stones are not removed.

4. Improved Urinary Function :- Urine can flow normally again, reducing risk of hydronephrosis and discomfort.

5. Effective for Large or Complex Stones :- Surgery can treat stones that do not respond to non-invasive methods.

Risks and Complications

Though generally safe, surgery carries some risks:

1. Infection :- Infections may occur post-surgery but are typically managed effectively with prescribed antibiotics and proper hygiene to prevent complications.

2. Bleeding :- Though uncommon, minor bleeding may occur, especially in PCNL or open procedures, and is usually controlled without further intervention.

3. Injury to urinary tract :- Rare cases involve accidental damage to the urinary tract, which may need follow-up procedures or temporary stent placement to heal.

4. Pain or discomfort :- Patients may experience mild to moderate pain or discomfort at the surgical site or during the passage of stone fragments.

5. Stent discomfort :- A temporary stent might cause a feeling of irritation or urgency while urinating, which resolves after its removal.

6. Recurrence of stones :- Kidney stones can return if dietary and lifestyle habits aren’t improved, making prevention and regular follow-up essential.

Post-Surgery Recovery

Hospital Stay

URS or ESWL :- Often same-day discharge.
PCNL :- 1–2 days of hospitalization.
Open surgery :- 3–5 days or more.

Recovery Timeline

Most patients return to normal activities in a few days to 2 weeks depending on the procedure.
Avoid strenuous activities during recovery.
Stent removal may be scheduled within 1–2 weeks.

Follow-Up

Imaging may be repeated to confirm complete stone clearance.
Dietary changes and increased water intake are often recommended.
Medications might be prescribed to reduce stone recurrence.

Preventing Future Kidney Stones

Post-surgery care includes:

Hydration: Drink at least 2–3 liters of water daily.
Dietary modifications: Reduce salt, oxalate-rich foods, and animal protein.
Regular follow-ups: Monitor kidney health and detect early stone formation.
Medications: Some patients may benefit from medicines to control uric acid or calcium levels.

When to See a Doctor

Contact your doctor if you experience:

Severe pain after surgery
Fever or chills
Blood in urine beyond a few days
Difficulty urinating
Swelling or redness at the incision site

Conclusion

Kidney stone removal surgery is a safe and effective solution for those suffering from large or obstructive stones. With advancements in minimally invasive techniques, patients experience less pain, quicker recovery, and improved outcomes. If you’ve been struggling with kidney stones, consult a specialist to determine the right surgical option for you. With the right care and preventive approach, you can live stone-free and pain-free.