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4 Types of Kidney Stone Operations You Need to Know

Kidney stone surgery is a surgical procedure performed to remove stones that are in the kidneys as well as the ducts and bladder. This surgical procedure can be done with minimal surgical incision or conventional surgical techniques, depending on the size of the stone, the severity, and the general condition of the patient.

Kidney stones can occur along the urinary tract, ranging from the kidneys, ureters, bladder, to the urethra or urethra. Kidney stones also need to be treated immediately if it has caused certain symptoms, such as low back and low back pain, pain during urination, reduced amount of urine, and red or brown urine.

When is kidney stone surgery needed?

Small kidney stones can generally be handled independently at home, for example by increasing drinking water. The goal is that the stone can come out through urine.

However, kidney stones are large in size can cause blockages in the flow of urine so it needs to be removed with medication or kidney stone surgery. Surgery is also needed if kidney stones are severe and risk causing complications in patients.

One procedure that can be performed by doctors to destroy kidney stones is extracorporeal shock wave lithotripsy or ESWL. Therapy of kidney stone breaking with shock waves is effective to destroy stones with a diameter of less than 2 cm.

Meanwhile, to remove or remove kidney stones that are more than 2 cm in size, your doctor may recommend kidney stone surgery. Kidney stones surgery generally needs to be done in the following conditions:

  • It has a very large size and is difficult to overcome with drugs and ESWL measures
  • Blocking urine flow and causing hydronephrosis
  • Cause severe symptoms such as severe pain and bleeding
  • Causes urinary tract infections

Types of Kidney Stone Surgery

The following are some types or techniques for kidney stone surgery that can be done to treat kidney stone disease:

1. Cystoscopy

Cystoscopy aims to remove stones in the urethra and bladder. Before undergoing cystoscopy, sufferers will be given anesthesia or anesthesia first.

After the anesthesia works, the doctor will insert a cystokop (a special instrument resembling a hose equipped with a camera at the end) through the urinary hole into the urinary tract or urethra to the bladder.

Stones in the urethra or bladder are then removed using a device that has been installed in the cystokop. After the stone has been successfully removed, sufferers are usually allowed to go home and move as usual.

However, if the patient underwent a total anesthesia cyst, it would likely be an overnight stay.

2. Ureteroscopy

Ureteroscopy aims to remove stones in the kidney and ureter using a ureteroscope, which is a device in the form of a camera hose. The work methods performed by the doctor are the same as the cystopy, namely:

  • Give anesthesia to patients
  • Insert a ureteroscope into the ureter to look for a stone then crush and remove it
  • Use a laser or ESWL to break the stone if the size is too large and the stone can be removed with urine
  • Installing a special stent or tube made of metal in the urinary tract to expedite the flow of urine so that the remnants of small kidney stones can come out

After ureteroscopy is complete, sufferers are usually allowed to go home, but not allowed to drive their own vehicle. If ureteroscopy is performed under general anesthesia, the doctor will ask the patient to be in the recovery room until the anesthesia is gone.

Stents that are attached during kidney stone surgery with ureteroscopy may be removed within a few days or weeks.

3. Percutaneous nephrolithotomy or nephrolithotripsy (PCNL)

PCNL is a kidney stone surgery with a small incision to remove kidney stones that are more than 2 cm in size or cannot be treated with ESWL methods or cystoscopy and ureteroscopy.

This procedure is also done if kidney stones have caused an infection in the kidneys or severe pain that cannot be treated with medication.

PCNL uses a device called a nephroscope, an instrument in the form of a camera hose at the end. This tool is inserted directly into the kidney through a small incision made by a doctor on the patient's back.

The PCNL procedure can be done in two ways, namely:

  • Nephrolithotomy, which is lifting and removing stones in intact condition.
  • Nephrolithotripsy, which is breaking stones using a laser or sound waves, then kidney stones are pushed out using a machine.
After surgery, patients need to be hospitalized for at least 1-2 days.

4. Open operation

Surgery or open surgery is a kidney stone surgery technique that is now quite rarely done. However, this kidney stone surgery may be done on a large size kidney stone condition and the following conditions:

  • Kidney stones are not successfully removed or removed by other kidney stone surgery methods
  • Kidney stones clog the ureter or channels that carry urine from the kidneys to the bladder
  • Kidney stones inhibit the flow of urine so that urine cannot be expelled smoothly
  • Bleeding or infection occurs
  • Severe pain due to kidney stones (renal colic)

Open surgery begins with general anesthesia. Next, the doctor will make an incision on the patient's back as a way to remove kidney stones.

Compared to other procedures, open surgery requires longer recovery time and hospitalization compared to other kidney stone surgery techniques. Patients may only be able to recover fully in about 4-6 weeks after undergoing open surgery.

In addition to the 4 types of kidney stone surgery above, there are other procedures that can be done to treat kidney stones based on the cause.

For example, the condition of hyperparathyroidism can increase calcium in the blood and cause kidney stones to form. This condition needs to be treated with hyper parathyroid treatment, including hyper parathyroid gland surgery if needed.

Management of kidney stones through ESWL and kidney stone operations are generally relatively safe to do. However, as with other surgical procedures, kidney stone surgery still has a postoperative risk, such as urinary tract infections, bleeding, narrowing of the ureter or urinary tract due to surgical wounds, to side effects on the anesthetic.

Before kidney stone surgery is performed, the doctor will provide information to patients about the preparation, benefits, and side effects of kidney stone surgery that will be undertaken.

If you suffer from kidney stones and are advised by your doctor to undergo kidney stone surgery, be sure to understand what the doctor explains and do not hesitate to ask if there are things that you do not understand.