Kidney stones can be incredibly painful and disruptive to your daily life. Fortunately, modern medicine offers several effective treatments to help you regain your comfort and well-being. Among these treatments are three minimally invasive procedures: Ureteroscopy (URSL), Extracorporeal Shock Wave Lithotripsy (ESWL), and Retrograde Intrarenal Surgery (RIRS). Let’s explore the scope of these advanced kidney stone treatments.
Ureteroscopy (URSL)
Ureteroscopy, often referred to as URSL, is a minimally invasive procedure used to remove or break down kidney stones. The urology surgeon uses a thin, flexible tube called a ureteroscope, which is inserted into the urinary tract through the urethra to locate and treat kidney stones directly.
How Is It Done?
- You will be given local anesthesia to ensure you have a painless, comfortable experience throughout the procedure. If the stones are too big or are located in a tricky spot and require manual extraction, general anesthesia will help you sleep through the procedure.
- The urologist inserts the ureteroscope through the urethra, guiding it up to the location of the kidney stone.
- Once the stone is located, various techniques can be used to remove or fragment it, such as laser lithotripsy.
- Smaller stone fragments may pass naturally. In some cases, a temporary ureteral stent may be placed to help urine drain properly and to ensure that any stone fragments can pass without obstruction. The stent is removed in a follow-up procedure. For larger stone fragments, a small basket or grasper-like instrument may be used to grasp and remove them.
- You will be discharged after a small period of observation or overnight stay.
- Follow-up visits are required to ensure that you are passing the stones healthily and recovering from the procedure without any complications.
Benefits of URSL:
- Effective for a wide range of stone sizes and locations.
- Minimally invasive, resulting in shorter recovery times.
- High success rates and low complication rates.
- Reduced pain and discomfort compared to open surgery.
Extracorporeal Shock Wave Lithotripsy (ESWL)
ESWL is a non-invasive procedure used to break down kidney stones from outside the body. It employs shock waves to target and disintegrate the stones which then pass through the urethra while you pass urine.
How Is It Done?
- It is a comparatively painless procedure done without any sedation. You will ideally lie on the operation table comfortably as the urologist performs the procedure.
- A specialized machine will locate the kidney stone precisely. The surgeon will use a device called the lithotripter to deliver shock waves to the stone, causing it to break into smaller pieces. At this point, you might feel some pressure or snapping. However, it is not painful and is usually well-tolerated.
- Over time, the smaller stone fragments pass through the urinary tract naturally.
- After the procedure, it is common to experience some soreness or discomfort in the area where the shock waves were applied. This can be managed with painkillers.
- You can go back home the same day and resume regular life after a couple of days.
- However, follow-up is required as advised to keep an eye on whether or not the fragments are passing normally.
Benefits of ESWL:
- Non-invasive, meaning no incisions are made.
- Quick procedure with minimal recovery time.
- Effective for smaller kidney stones.
- Reduced risk of infection compared to invasive surgeries.
Retrograde Intrarenal Surgery (RIRS)
Retrograde Intrarenal Surgery (RIRS) is a minimally invasive procedure used to treat kidney stones located within the kidney and upper urinary tract. The surgeon uses a flexible ureteroscope and specialized instruments to access and remove the stones.
How Is It Done?
- The procedure begins by administering local anesthesia so that you remain comfortable throughout the procedure.
- When you are numb, the urologist inserts a flexible ureteroscope through the urethra, up into the ureter, and finally into the kidney where the stone is located.
- The stones are broken into tiny fragments using laser technology and subsequently removed. Smaller fragments may pass naturally, while larger fragments may be removed using a basket-like device. In some cases, a temporary ureteral stent may be placed to ensure urine can pass freely from the kidney to the bladder while any swelling or irritation heals. Stents are typically removed in a follow-up procedure.
- You may be discharged after a few hours of observation. However, if there are any complications, you may need to stay overnight.
Benefits of RIRS:
- Effective for stones in difficult-to-reach locations.
- Minimally invasive, reducing post-operative pain and recovery time.
- High success rates in stone removal.
- Lower risk of complications compared to open surgery.
URSL, ESWL, and RIRS are advanced kidney stone treatments that offer patients effective alternatives to traditional open surgery. These minimally invasive procedures not only reduce discomfort and recovery time but also provide high success rates in treating kidney stones of varying sizes and locations. If you’re experiencing kidney stones, consult our chief urologist, Dr. Priyank Salecha, to determine the most suitable treatment option for your condition and regain your quality of life.
