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%)

Follow-up

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