#shorts PreOp® Patient Education & Patient Engagement
Kidney Stones Surgery - PreOp® Patient Education & Patient Engagement
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The normal body has two kidneys, in the middle of the back, under the lowest ribs. Kidneys filter and clean blood to make urine. Ureters drain urine from the kidneys to the bladder.

The bladder empties urine from the body through another tube called the urethra.

The urinary tract includes all of these structures the kidneys, ureters, bladder, and urethra.

Kidney stones start as tiny crystals of minerals that stick together when urine is concentrated. This happens with dehydration.

Crystals build into stones as more minerals deposit, similar to how a pearl builds in an oyster.

Most small stones pass out of the body, carried by urine.

Larger stones tend to remain in the kidney or become stuck as they move down the ureter.

About 1 in 10 people are affected by kidney stones in their lifetime.

Dehydration, family history, and some medical conditions increase the risk of stone formation.

Symptoms and problems often begin when urine flow is blocked by a stone. This can lead to severe pain, complicated infection, and blood in the urine. These problem stones are a risk for kidney damage.

Many of these stones eventually pass without surgery. This is called expectant management. Medications may be prescribed for pain, infection, and to help the stone pass. Rest, heat, and ice may also be recommended. It can take days to weeks for some small stones to pass on their own.

Surgical treatment can be necessary,
when a small stone doesn’t pass with expectant management,...
for stones too large to pass on their own,...
any stone causing infection with fever, and…
for uncontrolled pain, especially with nausea and vomiting.

Stones larger than half a centimeter are more likely to need intervention.

Some stones need more than one surgery, especially stones larger than 2 centimeters.

Procedures for managing kidney stones that may be considered include:
cystoscopy,
ureteroscopy,
stent placement,
PCNL
ESWL

We will discuss each of these in more detail to get a better understanding of how, when, and why they may be used.

Most of these procedures are performed using scopes, long instruments with a light, and a camera.

The surgeon uses different scopes for different functions, to see and operate on places inside the urinary tract.

Cystoscopy is the most basic procedure on the list. The surgeon uses a scope to look inside the urethra and bladder for stones and other problems.

When needed, guidewires and dilators are passed through the cystoscope into the ureter.

During a ureteroscopy, a thinner scope is used. This is guided further, through the bladder, into the ureter, and sometimes up to the kidney.

Once kidney stones are reached, other tools are used to break the stones apart and pull the pieces out.

Placement of a temporary stent is often a necessary step before, during or after the procedures we have discussed so far.

This thin, straw like, tube is passed through a cystoscope into the ureter then guided up to the kidney. The curl at each end holds the stent in place.

Stents keep the kidney draining. They are temporary, but may be needed for days or weeks. Stents can relieve stone pain, and dilate the ureter to help a stone pass. Stents are placed while an infection is being treated, before a stone can be removed. Stents are also needed while the ureter heals after some procedures.

The most appropriate procedures for you depend on the size and location of the stone or stones, the severity of the blockage, and your other medical conditions.

Before your surgery, understand which procedures are planned or may become necessary to treat your kidney stone.

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