Kidney Stones - Prevention

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The shattered stone fragments may cause discomfort as they pass through the urinary tract. If so, the doctor may insert a small tube called a stent through the bladder into the ureter to help the fragments pass. This practice, however, does not usually speed up passage of the stones and is not used routinely.

Extracorporeal shock wave lithotripsy (SWL) is a procedure used to shatter simple stones in the kidney or upper urinary tract. Ultrasonic waves are passed through the body until they strike the dense stones. Pulses of sonic waves pulverize the stones, which are then more easily passed through the ureter and out of the body in the urine.

SWL has a 50 - 90% success rate, depending on the location of the stone and the surgeon's technique and experience. Recovery time is short. Most people can resume normal activities in a few days.

SWL is generally safe, and has few complications. If they do occur, complications may include:

Blood in the urine, the most common complication, may last for a few days after treatment. To reduce the chances of bleeding, doctors usually tell patients to avoid taking aspirin and other NSAIDs, which can promote bleeding, for 7 - 10 days before the treatment.

Bruising and minor discomfort due to the shock waves are common in the back or abdomen.

Sometimes the stone does not completely break up with one treatment, and additional treatments may be required. Inability to pass stone fragments may also be a particular problem in patients who have cysts or other kidney problems.

SWL does increase the risk of damage to the kidneys.

SWL appears to be safe for children. Experts recommend using the least amount of shocks and impact possible in young people. If more than one treatment is needed, the patient should wait at least 15 days before the next treatment.

Ureteroscopy

Ureteroscopy may be used for stones in the middle and lower ureter. Because it uses smaller instruments, this procedure can be done successfully in children. During ureteroscopic stone removal:

The patient receives a general anesthetic, though no incision is required for the procedure.

The surgeon passes a small fiberoptic instrument called a ureteroscope through the urethra and bladder into the ureter.

The surgeon locates the stone or stones.

The urologist can use a laser to break up the stones, or remove them with a basket, grabber, or suction tool.

The surgeon may decide to leave a small tube, or stent, in the ureter for a few days after treatment, to help the lining of the ureter heal.