Laser Kidney Stone Surgery
What is it?
Minimally invasive surgical techniques to treat urinary tract stones
A long thin rigid telescope or a fibre-optic flexible telescope (ureteroscope) is introduced into the upper urinary tract (ureter and kidney) via the urethra (penis in men) and bladder. A special high powered holmium laser together with microbaskets are used to manipulate, fragment and remove stones. A miniature jack hammer (pneumatic lithoclast) is also sometimes used.
What are the main advantages of this approach?
- Generally considered a very safe procedure with minimal postoperative pain and return to normal activities within 24 hours.
- Allows multiple stones of any composition, in any location within the ureter and kidney to be treated without the need for any incisions
- A highly successful technique (over 90%)
- Can be performed as day / overnight surgery
What are the risks with laser kidney stone surgery and what should I expect after the operation?
- Expect some burning on passing urine (An over the counter medication Ural can reduce the stinging sensation during urination)
- Blood in urine and possible passage of small stone fragments can occur for a few days to a week
- Infections – stones can harbor bugs and treatment of stones can precipitate an infection which is why Dr Louie-Johnsun will usually give you antibiotics around the time of your surgery. Rarely the infections can be severe and require hospitalisation in a high dependency area.
- Incomplete stone clearance / need for future procedures (5-10%). For large or multiple stones, repeat procedures are often expected
- A thin, hollow tube is placed inside the ureter called a Ureteric stent in most cases for a short period, to ensure the kidney drains without the risk of blockage from stone fragments, blood clot and swelling after operation (click here for information on ureteric stents)
- Small risk of damaging the ureter (0.5%)
- After surgery, you will be advised on the necessary follow-up arrangements.
- You need to drink approximately 8 glasses of water a day (2.5L/day).
- Simple analgesics such as Panadol and Nurofen are usually all that is required, occasionally stronger medication (eg. Panadeine Forte) or medications for stent irritation may be necessary.
- You will not be able to drive for at least 24 hours after being given the general anaesthetic.
- Depending on your overall “stone burden” and previous stone episodes, Dr Louie-Johnsun may arrange for 24 hour urinary studies, blood tests and referral to a renal physician.
- Ensure arrangements have been made to remove your stent
Click here for Other Surgical Treatments for Kidney / Urinary Tract Stones