Procedures for kidney stones

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Smaller kidney stones have a higher chance of passing spontaneously and can be safely managed at home. Some patients may require surgery in some circumstances. Reasons for this can include; if the pain cannot be adequately managed, the size of the kidney stones, infected kidney stones, or kidney stones that have failed to pass after an appropriate period.  

Ureteroscopy

A ureteroscopy is a procedure that is often completed by urologists to remove kidney stones. A fine camera is passed internally, via the bladder to the ureter (tube transporting urine from the kidneys to the bladder). This allows direct inspection of the kidney. Once the kidney stones are located, a laser is used to break and clear the kidney stones. In many cases, a ureteric stent may be needed and inserted in the ureter as part of this procedure. A stent is a fine rubber tube. This tube is important because it  allows urine and fine stone debris to drain into the bladder, and relieve obstruction and pain. This tube is internal, with no wires or tubes outside of the body. The stent is only temporary and can be removed with a simple procedure under local anaesthetic. 

Preparing for your operation

If you are advised that you are undergoing a ureteroscopy, please inform the clinic if you are:

• On blood thinning medications
• Allergic to contrast or iodine
• Under 50 if you are female (you will need a pregnancy check before surgery)

Risks of surgery

• Bleeding (can be present until the stent is removed)
• Discomfort in the back
• Infection in less than 5-6% of cases
• Frequent need to empty the bladder. This is known as urinary irritation and can be present until the stent is removed
• Unable to access the stone on the first attempt. This can occur in 15% of cases, due to anatomical factors where the ureter is too tight to allow the camera to safely reach the accurate position. If this happens, a stent may have to be inserted to allow the ureter to dilate gently to improve the success rate of the subsequent procedure. 
• Incomplete clearance of kidney stones, especially with poor vision from cloudy urine or debris from large stones. Should this occur, a repeat inspection may be required to confirm clearance of stones
• Ureter injuries can occur, although rare and in most cases can be managed with a stent for 4-6 weeks. 

Recovery after your surgery

You will most likely be able to return home on the same day. You will be advised to drink plenty of water to help with drainage of the urinary system. 

If a stent is inserted, you may get a script for pain killers. It is important to know that you may get some stent irritation if one was inserted during surgery.  Stent irritation is common (up to 95% of patients will have it). The stent will usually be removed under local anaesthetic with flexible cystoscopy. You will be contacted by the clinic to organise this appointment.  

When should I be concerned?

There are some things to look out for as you recover after your surgery. These include symptoms like:

• Unable to pass urine
• Passing large blood clots in urine
• Fever with temperature >38 degrees

If any of the above symptoms occur, please contact the clinic on (08) 6317 3464 during the hours of 9am – 5pm, Monday to Friday. For medical emergencies after hours, go to your local emergency department.