• Kidney Disease

Everything You Need to Know About Kidney Stone Surgery

Medically reviewed and edited by Madalaine Hayes, MSN, FNP

Although kidney stones are a common condition, the thought of undergoing treatment to remove them can be overwhelming. However, these procedures are widely recognized and established.

Millions of Americans undergo successful kidney stone surgeries each year, and understanding what to expect can give you peace of mind regarding your procedure.

In this article, we’ll take a closer look at the different types of kidney stone surgeries, how they work, and what to do afterward to prioritize your health.

What are Kidney Stones?

Kidney stones are small, hard deposits that form in the kidneys. The most common type of kidney stone is composed of calcium, and the second most common is oxalate. There are also kidney stones that form from struvite, which are composed of a mixture of magnesium, ammonium, phosphate, and calcium carbonate. In addition, high levels of uric acid in the blood can sometimes lead to the formation of uric acid kidney stones.

Despite their location, kidney stones impact the urinary tract more than the kidney.

This is because these stones typically form when urine becomes concentrated — due to dietary habits, dehydration, or genetic factors — allowing minerals to crystalize and stick together.

Symptoms of kidney stones

If you have small kidney stones, you may be asymptomatic. However, they are usually quite painful, and you’re likely to experience the following symptoms:

• Severe pain in the lower back, abdomen, and groin

• Painful urination

• Blood in the urine

• Cloudy or foul-smelling urine

• Nausea and vomiting

• Frequent urination

• Fever and chills

It’s important to seek medical attention if you experience any of these symptoms, as untreated kidney stones can cause more serious complications — such as infections and organ damage.

Your doctor can offer a professional diagnosis and treatment plan to manage your condition. Keep in mind that the type of treatment plan will depend on the type of kidney stone you have.

When Does Kidney Stone Surgery Become Necessary?

While most kidney stones can naturally pass through the urinary tract — especially if they’re small enough — there are situations where surgery is required.

Limitations of nonsurgical treatments

Nonsurgical methods that can help treat kidney stones may include strategies like hydration therapy, pain management, and medication.

However, these methods may come with limitations, such as:

• Size of the stone: Stones larger than five millimeters may have difficulty passing on their own and can cause persistent symptoms or complications.

• Location of the stone: Stone fragments stuck in certain locations — such as the ureter — may not be able to move on their own and require surgical intervention.

• Pain management: While pain medications can provide relief, they don’t address the underlying issue. This means that they may not be a good long-term solution, especially for problematic kidney stones.

• Recurring stones: Patients with a history of recurrent kidney stones may need more definitive treatment to prevent future occurrences.

Depending on these factors, nonsurgical treatments may not be effective for your situation, and you may need to take a more aggressive approach.

Specific indications

Surgery for kidney stones may also be considered under certain circumstances, depending on factors like:

• Persistent symptoms: Ongoing pain, infections, or bleeding that does not resolve with nonsurgical treatments.

• Obstruction: Stones that cause blockages in the urinary tract, leading to urine flow obstruction and potential kidney damage.

• Size and composition: Stones that are too large to pass naturally or made of materials that medications can’t dissolve.

• Failed nonsurgical treatment: When stones do not pass after a reasonable period of using nonsurgical treatment for kidney stones or if there's an increase in stone size.

• Kidney function: Stones that pose a risk to kidney function or cause recurrent urinary tract infections.

• Patient's health status: Underlying conditions may increase the need for surgical intervention to prevent complications.

Types of Kidney Stone Surgery

Extracorporeal shock wave lithotripsy (ESWL)

ESWL is a noninvasive procedure that uses sound waves to break kidney stones into smaller pieces and help them pass through the digestive tract more easily.

This method is most effective for stones located in the kidney or upper ureter that are less than 2 centimeters in size.

The procedure is typically outpatient, meaning you can go home on the same day.

ESWL also has minimal recovery time, but multiple sessions may be required to ensure that all stones are removed completely.

Ureteroscopy (URS)

This procedure involves the insertion of a thin, flexible scope — called a ureteroscope — through the bladder and into the ureter or kidney.

Your doctor will then use the scope to locate and remove the stones. If the stone is too large to remove in one piece, it can be broken up using a laser device.

URS is normally used to remove stones of various sizes located in the lower ureter. It’s often more effective compared to options like ESWL and doesn’t require multiple sessions.

The procedure is performed under general anesthesia, and you’ll be able to go home after a day or two.

Percutaneous nephrolithotomy (PCNL)

PCNL is a minimally invasive surgical procedure recommended for stones that are bigger than two centimeters or when other methods have failed.

It involves making a small incision in the back to insert a nephroscope directly into the kidney to locate and remove the stone.

PCNL requires hospitalization and has a higher success rate for removing large stones compared to ESWL and URS.

Open surgery

Open surgery for kidney stones is rare and is typically only reserved for extremely large stones, abnormal organ anatomy, or when other procedures aren’t possible.

This conventional surgical approach involves a larger incision in the side or abdomen to directly access the kidney and remove the stone.

Open surgery has a longer recovery time and a higher risk of complications, which is why it’s only used as a last resort.

Preparing for Kidney Stone Surgery

Properly preparing for kidney surgery can help you ensure an effective recovery process without additional complications. Here’s what the preparation process involves.

Preoperative assessments

Before undergoing surgery, your doctor will perform several assessments and tests to determine your health status and plan the procedure. These tests usually include:

• Medical history review

• Physical examination

• Blood tests

• Imaging tests to help locate the stones

• Urine tests

Your doctor may also recommend stopping certain medications or supplements that could heighten your risk of complications during the procedure.

Risks and expectations

While kidney stone surgery is generally safe, it’s essential to understand the potential risks and how to mitigate them. Common issues that may develop include:

• Minimal bleeding

• Infections

• Pain

• Injury to surrounding organs, characterized by severe pain, swelling, and bruising

In most cases, your doctor will give you medication to prevent risks like infections and pain.

If you develop more serious issues — like organ injury and substantial bleeding — seek emergency medical attention.

Home recovery tips

You might need to take a few days off after your surgery to recover. Following these guidelines can help you make the most of your recovery:

• Follow pain management advice: Use medications as prescribed to manage pain and other post-surgery symptoms.

• Stay hydrated: Drink plenty of water to flush the urinary system and aid your recovery. It will also help to prevent digestive issues that may worsen your pain after surgery.

• Rest: Allow the body enough time to heal, but try to engage in light activity to prevent complications such as blood clots. Consult your doctor about appropriate exercises to ensure a safe recovery.

• Diet: Eat a balanced diet rich in fiber to prevent constipation, which can worsen pain from surgery.

• Wound care: If incisions were made, follow your doctor's instructions for keeping the area clean and dry.

Potential complications

While complications after kidney surgery are rare, it’s important to know which signs may indicate a problem. These may include:

• Persistent or severe pain that seems to worsen

• Fever and chills

• Difficulties urinating

• Visible blood in urine caused by significant bleeding

If any of these symptoms occur, contact your doctor immediately to avoid further issues.

Preventing Recurrent Kidney Stones

Kidney stones can be a recurring problem for many people who develop new stones within five to seven years.

However, there are effective ways to prevent the formation of new kidney stones. We’ll take a closer look at these in this section.

Dietary modifications

Making changes to your diet is often one of the best ways to prevent kidney stones. Your doctor may recommend the following changes. Keep in mind that modifications will be tailored to the specific type of kidney stone that you have or are at risk of developing.

• Reducing your sodium intake by avoiding processed foods, canned products, and takeout meals

• Limiting animal protein

• Cutting back on calcium-rich foods

• Eating more fruits and vegetables

These adjustments can help lower the salt and minerals in the body that normally allow kidney stones to form, preventing new ones from developing.

The importance of hydration

Staying well-hydrated is essential for preventing recurrent kidney stones, as fluids dilute the substances in urine that lead to stone formation.

Water is usually the best fluid to consume and it’s recommended to aim for eight glasses per day, depending on your activity level.

Medications

For some individuals, dietary and lifestyle changes alone may not be enough to prevent kidney stones.

Depending on the type of stones you have and how they’re formed, your doctor may recommend specific medications to prevent the development of new ones.

These medications typically alter the salt and mineral levels in the urine, reducing the risk of new stones.

Where Can You Learn More About Kidney Stones?

While LifeMD offers care to patients with chronic conditions, kidney stones are a serious condition that requires ongoing specialty care and extensive work from an in-person healthcare provider.

This being said, if you’re concerned about your kidney health, LifeMD may be able to help.

LifeMD can offer guidance on ways to maintain healthy habits that may support the management of your condition and avoid further complications.

Additionally, a licensed medical provider may be able to treat other conditions contributing to kidney stones.

Your healthcare provider may offer guidance on effective ways to help you stay healthy and/or prescribe the appropriate medication.

Make an appointment today to get started.

Madalaine Hayes, MSN, FNP

Madalaine earned her Master’s of Science degree with a specialization in Family Nurse Practitioner from Florida Atlantic University. She’s dedicated to ensuring her patients feel supported and valued throughout their entire healthcare journey. A passionate traveler, Madalaine loves exploring the world with her family and creating lasting memories across the globe. She’s also an avid reader, and she’s curated an extensive home library that encompasses a diverse range of literary genres. Whether she’s embarking on new adventures with loved ones or engrossed in the pages of a captivating novel, Madalaine finds immense joy in the rich experiences that life and literature bring.

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