Treating Kidney Stones
In most cases, we recommend medical expulsive therapy to treat a stone. This includes the use of alpha blocker medicines to help patients pass kidney stones. This method can increase the spontaneous passage of the stone while decreasing the time it takes to pass.
Depending on the size and location of the stone, as well as the overall health of the patient, we may recommend minimally invasive surgery. The Miriam is home to the Minimally Invasive Urology Institute.
The latest in minimally invasive surgery
Performed in an outpatient setting or at The Miriam Hospital, the Kidney Stone Center provides the following options for minimally invasive surgery:
Shockwave lithotripsy: The most common non-invasive technique is shockwave lithotripsy, which uses sound waves delivered outside the body to dissolve the kidney stone to a passable size.
Performed with local anesthesia on an outpatient basis, this treatment usually lasts approximately 20 minutes and has a success rate of approximately 70 percent. The patient may experience some pain in passing the stone remnants.
Ureteroscopy: In ureteroscopy, a small scope is inserted into the urethra and through the urinary system while the patient is under general anesthesia. A laser is used to break up the stone and extract the pieces. Because the anatomy of the urinary system is very small, the scope can cause the urinary tubes to swell, affecting the patient’s ability to urinate. Stents may be placed in the tubes to allow patients to urinate while the tubes recover. The stents are removed one week after the procedure and can cause minor discomfort and, initially, may cause frequent urination.
Ureteroscopy is performed on an outpatient basis; it usually lasts 45 minutes and has a success rate of approximately 95 percent.
Percutaneous nephrolithotomy: If a stone is too large to treat with shockwave lithotripsy or ureteroscopy, a procedure known as percutaneous nephrolithotomy may be necessary to remove the stone. While the patient is under general anesthesia, a centimeter-long incision is made in the back, through which a tube is placed into the kidney. Through this tube a small device is inserted to break up the stone and retrieve the pieces. This procedure typically requires a one- to two-day hospital stay and has a success rate of approximately 95 percent.
Critical follow-up services
After a stone has been passed or removed, it is sent for chemical analysis. Knowing the composition of a stone is helpful in determining a patient’s dietary medical management after treatment – specifically regarding calcium intake. Such steps are critical for the prevention of stone formation.
Pain is typically managed with oral medication. However, medication for acute pain caused by stones is often delivered intravenously, most often in an emergency room setting.