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Kidney Health

Treating Kidney Stones


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Summary & Participants

How your kidney stones are treated will depend on the size, location and type of stone you have. Our panel of experts will discuss the different options, and how you and your doctor can decide which one is right for you.

Medically Reviewed On: July 21, 2009

Webcast Transcript


JON MARKS, MD: Well, the kidney is traumatized by the presence of the shockwaves and by the entire interaction of the shockwaves with the stone. So it is not uncommon for the patients to experience what we call hematuria, which is some blood in the urine. The urine may turn light pink for a day, and then it clears up as the kidney heals.

PAUL MONIZ: How long till they can go back to work with lithotripsy?

JON MARKS, MD: As mentioned, frequently the following day.

PAUL MONIZ: Dr. Salant, if lithotripsy doesn't work, then what?

ROBERT SALANT, MD: There are some stones that are just not amenable to lithotripsy, either because of the size or the location. There are other somewhat more invasive procedures prior to doing any open surgery to address these stones. One method to get to the stones and break up the stones without making any incisions in the body is using thin telescopes that go in through the urethra and up to the level of the stone. These are called endourologic techniques. These very thin telescopes are used to directly visualize the stones. Then the stones can either be grasped in a basket and pulled out in one whole piece, or if the stones are large, they may be broken up using various sources of energy such as ultrasound, laser or electricity.

PAUL MONIZ: So you go in using what kind of an instrument? You go in through the urethra?

ROBERT SALANT, MD: We go in through the urethra using a very thin telescope which is directed up to the level of the stone. Then under direct vision, the stone is then broken up using one of the energy sources.

PAUL MONIZ: Just for our audience, the urethra is?

ROBERT SALANT, MD: The urethra is the tube where the urine comes out from the bladder. So in the male, it's through the penis, and in the female, it's just above the level of the vagina.

PAUL MONIZ: If that doesn't work, Dr. Marks, what happens next?

JON MARKS, MD: For stones that are large that reside in the kidney, these are not appropriate to be treated with shockwave lithotripsy.

PAUL MONIZ: Like this one here. If a patient came in and had this particular size.

JON MARKS, MD: This would not be appropriate to treat with shockwave lithotripsy. In years gone by, we would have done an open operation. But now we can do what's known as percutaneous nephro-lithotripsy, not to be confused with shockwave lithotripsy. That's a procedure whereby we make a small hole in the patient's back. We insert other kinds of telescopes directly into the stone under radiographic guidance using fluoroscopy. We apply various energy sources to the stone to break it up, and we physically remove large chunks of the stone through this small hole that we made in the patient's back.

PAUL MONIZ: If you have to split the kidney, as it were, in the most extreme case, there are some complications involved. Potentially.

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