Do I Need Surgery for My Kidney Stone?

Kidney stones are small, hard deposits that can form in one or both of your kidneys. Created by a build-up of minerals, these deposits are usually passed through the urinary tract without issue. Unfortunately, a larger stone can become lodged inside the ureter — the small tube between the bladder and kidney. While kidney stones are usually no larger than a tiny pebble, they can cause immense pain for those struggling to pass them. 

If you’re a patient suffering from kidney stones, you may be wondering whether you’ll need to undergo surgery. Here are five important questions to consider about stone removal and treatment options: 

How Do I Know If My Kidney Stone Requires Surgery? 

Kidney stones often pass on their own without any medical intervention. However, surgery may become necessary to break up or remove some stones. Those reasons include when the stone:

• Is too large to pass on its own 

• Has become stuck in the ureter tube after moving through the urinary tract 

• Blocks the flow of urine

• Results in one or more urinary tract infections 

• Causes unbearable pain that needs to be alleviated

In these situations, surgery will help the stone pass and relieve the pain. 

What Does Surgery for Kidney Stones Entail?

Most kidney stone surgeries do not require an actual incision. Rather, urologists are able to perform procedures through a patient's natural orifices, meaning the urethra and ureter. During the procedure, referred to as ureteroscopy, a urologist uses a small flexible camera (scope) to locate the stone. From there, they will often use a tiny wire basket or laser fiber to capture the stone and pull it out, or break it up into tiny fragments that are removed. 

In other cases, urologists may not need to enter the body at all to treat the stone. Shockwave lithotripsy (SWL) is used to break the stone apart into tiny fragments by transmitting ultrasound waves through the patient’s back while they are under anesthesia. 

A more invasive surgery called percutaneous nephrolithotomy (PCNL) may be needed for larger stones. During PCNL, the scope is inserted through a small incision in a patient’s back.

What Are the Risks Associated with Kidney Stone Surgery? 

First off, it’s important to remember that, if left untreated, kidney stones can lead to infections and loss of kidney function, not to mention substantial pain. That said, there are some risks and side effects associated with ureteroscopy. They include: 

• Potential injury to the ureter during the procedure 

• Risk of developing a urinary tract infection

• The need for a temporary, post-surgery stent to assist with drainage or healing of the ureter 

• The need for repeat surgical sessions for larger or more difficult-to-treat stones

Be sure to ask your urologist about your specific surgical options and any risks associated with it. 

Are There Nonsurgical Options for Treating Kidney Stones?

Yes. Fortunately, medical expulsive therapy may be used to help patients pass their stones using certain medications that relax the ureter tube. 

Why Do I Keep Getting These Kidney Stones? 

The majority of stones are caused by lack of proper hydration. This allows salts and minerals to crystallize in the urine. Some stones also may be caused by urinary stasis or chronic infections in the urinary tract. Some patients may experience kidney stones as a side effect of their medication for controlling headaches or migraines, blood pressure or viral infections such as HIV. Lastly, some patients may just have genetic abnormalities that predispose them to stone formation. 

Whatever the reason, some lifestyle modifications can help prevent stones from forming in the future. Proper hydration and nutrition  — such as limiting oxalate-containing foods — are the best ways to keep kidney stones at bay. Urine collection and analysis also can shed light on what predisposes some patients to stones. With this information, your urologist may prescribe you medications that help prevent the formation of kidney stones.