What Happens During Emergency Kidney Stone Removal? We Explain

 

Kidney stones can be incredibly painful, and in some cases, they require immediate medical attention. When a kidney stone becomes too large to pass naturally or causes severe symptoms, emergency kidney stone surgery may be necessary. Understanding what to expect during this urgent procedure can help alleviate concerns and prepare patients for a smooth recovery.

When Is Emergency Kidney Stone Surgery Necessary?

Emergency kidney stone removal is required when a patient experiences:

• Intense pain that persists despite taking medication

• Obstruction in the urinary tract causing kidney damage

• Infection leading to fever and chills

• Inability to urinate due to a blocked ureter

If any of these conditions occur, immediate medical intervention is crucial to prevent complications and ensure kidney function remains intact.

Diagnostic Process Before Emergency Surgery

Before performing emergency kidney stone surgery, doctors conduct several diagnostic tests to assess the severity of the condition:

• Imaging Tests—CT scans, ultrasounds, or X-rays help locate the stone and determine its size.

• Urinalysis—A urine test checks for infection, blood, and other abnormalities.

• Blood Tests—These help assess kidney function and detect any underlying issues.

Once the diagnostic process is complete, the urologist will decide the most appropriate surgical procedure based on the size, location, and severity of the kidney stone.

Types of Emergency Kidney Stone Surgery

1. Ureteroscopy (URS)

Best for: Medium-sized stones located in the ureter or kidney.

Ureteroscopy is a minimally invasive procedure where a thin, flexible scope is inserted through the urethra and into the bladder and ureter. The surgeon uses laser technology to break the stone into smaller fragments, making it easier to pass naturally or remove using a special tool.

Procedure Steps:

• Patient receives general or spinal anesthesia.

• A small camera-equipped scope is guided through the urinary tract.

• The kidney stone is either removed directly or broken into pieces using a laser.

• A temporary stent may be placed to aid urine flow during recovery.

Recovery: Most patients go home the same day with mild discomfort and are advised to drink plenty of fluids.

2. Extracorporeal Shock Wave Lithotripsy (ESWL)

Best for: Small to medium-sized stones in the kidney or upper ureter.

ESWL is a non-invasive procedure that uses sound waves to break kidney stones into tiny fragments, allowing them to pass through urine naturally.

Procedure Steps:

• The patient lies on a cushioned table while a shock wave machine targets the kidney stone.

• High-energy sound waves break the stone into small pieces.

• The patient is encouraged to drink water to flush out the fragments over a few days.

Recovery: Some patients may experience mild pain or blood in the urine for a short period.

3. Percutaneous Nephrolithotomy (PCNL)

Best for: large or complex kidney stones that cannot be treated with less invasive methods.

PCNL involves making a small incision in the back to access and remove the kidney stone directly.

Procedure Steps:

• The patient is under general anesthesia.

• A small tube is inserted into the kidney through a small incision.

• A surgical tool is used to break and remove the kidney stone.

• A nephrostomy tube may be placed temporarily for drainage.

Recovery: A hospital stay of one to two days is usually required, and full recovery takes about one to two weeks.

4. Emergency Stent Placement

Best for: Urgent relief of a blocked ureter before definitive stone removal.

A stent is a small tube placed inside the ureter to keep it open and allow urine to bypass the kidney stone. This is often done as a temporary measure to relieve pain and prevent kidney damage before scheduling definitive stone removal.

Procedure Steps:

• A thin tube is inserted through the urinary tract under anesthesia.

• The stent expands, allowing urine to flow past the blockage.

• The patient returns later for stone removal.

Recovery: Patients may experience mild discomfort, but the stent significantly improves urine flow and pain relief.

Post-Surgery Recovery and Care

After emergency kidney stone surgery, following post-operative care instructions is crucial for a smooth recovery:

• Increase Fluid Intake: Drinking plenty of water helps flush out stone fragments and prevents future stones.

• Manage Pain: Mild discomfort is common; pain medications may be prescribed if necessary.

• Follow Dietary Changes: Avoid high-oxalate foods (such as spinach and nuts) and reduce salt intake to lower the risk of new stone formation.

• Monitor Urination: Some blood in the urine is normal after surgery, but any signs of infection, such as fever or persistent pain, should be reported to a doctor.

Preventing Future Kidney Stones

To reduce the risk of developing kidney stones again, consider the following preventive measures:

• Consume sufficient fluids, ideally 8–10 glasses of water per day.

• Reduce sodium intake to prevent excessive calcium in urine.

• Incorporate citrus fruits like lemons and oranges to increase dietary citrate.

• Maintain a nutritious diet with proper calcium levels.

• Follow up with a urologist regularly for kidney health monitoring.

Conclusion

Emergency kidney stone surgery is often necessary when severe pain, infection, or urinary blockage occurs. Depending on the size and location of the stone, different surgical methods like ureteroscopy, ESWL, PCNL, or stent placement may be used. Understanding these procedures can help patients feel more prepared and confident about their treatment options. If you experience severe kidney stone symptoms, seeking immediate medical care is essential to prevent complications and ensure a quick recovery.

For expert urological care, visit AA Urology and schedule a consultation with our specialists today.