Removal of large kidney stones, or those unresponsive to conservative treatment, using percutaneous or retrograde intrarenal surgical methods.
Indication
- Large kidney stones (percutaneous nephrolithotomy is generally used for stones over 20 mm)
- Medium-sized stones (retrograde intrarenal surgery/RIRS for stones 5-20 mm)
- Stones unresponsive to shock wave lithotripsy (ESWL)
- Stones causing recurrent urinary tract infections
- Stones impairing kidney function or causing obstruction
- Staghorn stones
- Patients in whom stones cannot be passed due to anatomical anomalies
Preparation
- No food or drink for 8 hours before the procedure
- Blood tests, urine culture, and imaging (CT or ultrasound)
- If active urinary tract infection is present, antibiotic treatment is completed
- Blood thinners are adjusted with physician approval
- Pre-procedure anesthesia evaluation
How it's performed
- Under general anesthesia, the appropriate position is given (prone for PCNL, supine for RIRS)
- In the percutaneous method, the kidney is accessed through a small skin puncture
- In the retrograde method, a thin endoscope is advanced through the urinary tract
- Stones are fragmented into small pieces using laser or pneumatic energy
- Fragments are removed by aspiration or basket catheter
- A double-J (DJ) stent is generally placed at the end of the procedure
Post-procedure
- Hospital stay of 1-3 days (varies by method and stone burden)
- The DJ stent is generally removed in the outpatient clinic after 4-6 weeks
- Plenty of fluid intake and urine monitoring
- Avoidance of heavy lifting and strenuous activity for the first 2-4 weeks
- Stone analysis and metabolic evaluation with preventive recommendations
Risks
- Urinary tract infection and rarely urosepsis
- Bleeding and need for blood transfusion
- Injury to neighboring organs or pleura (rare)
- Stent-related discomfort, flank pain, or urinary burning
- Residual stones and the need for repeat procedures
FAQ
Are all kidney stones treated with surgery?
No. Most small stones can pass with adequate fluid intake and medical therapy. Surgery becomes an option for large, symptomatic, or obstructive stones.
Is open surgery still necessary?
Today, open surgery is rarely preferred for kidney stone treatment; the vast majority of cases are managed with closed (percutaneous or endoscopic) methods.
What is the purpose of the DJ stent?
It keeps the ureter open to facilitate urine flow, reduces edema, and helps fragments pass. It is generally removed within 4-6 weeks.
Can stones recur?
Kidney stones tend to recur. Dietary recommendations, fluid intake, and metabolic follow-up can reduce the risk of new stone formation.
Related Information
Related Medical Services
Other services in the same specialty or with similar indications you may want to explore.
ESWL (Extracorporeal Shock Wave Lithotripsy)
Urology
ESWL (extracorporeal shock wave lithotripsy) — non-surgical fragmentation of kidney and ureteral stones.
Ureteroscopy
Urology
Ureteroscopy (URS) — endoscopic visualisation and laser treatment of distal and mid-ureteral stones.
Ureteral Stent Placement
Urology
Ureteral (DJ) stent placement — an endoscopic procedure that keeps the ureter open.
Renal Cyst Treatment
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Renal cyst treatment — surveillance and surgical management of simple and complex kidney cysts.
Urological examination and evaluation
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Urological examination and evaluation — comprehensive clinical assessment of the urinary tract and male reproductive system.
Transurethral resection of bladder tumor
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TURBT — endoscopic removal and diagnosis of a bladder tumor through the urinary tract.
Kidney Disease Evaluation
Internal Medicine Outpatient Services
Kidney disease evaluation — early-detection-focused screening and follow-up with creatinine, eGFR and urinalysis.
Cystoscopy
Urology
Cystoscopy (bladder endoscopy) — endoscopic visualization of the urethra and the inside of the bladder.