Alternative Treatment Options
Open Surgical Treatment – With the invention of ESWL, open surgical procedures on the kidney are rare. There are, however, specific indications, which make open surgery necessary. These include:
- Failure of less invasive treatments due to size, composition and location of the stone
- Certain anatomic abnormalities of the urinary tract
Extracorporeal Shock Wave Lithotripsy (ESWL) – A minimally invasive treatment in which shock waves are generated outside of the body and focused on the urinary stone using a lithotripter. The shock waves break the calculi into small pieces that are passed out of the body naturally during urination.
Percutaneous Nephrolithotomy (PCNL) – This method is often used for calculi larger than 2 centimeters in size or for hard stones. General anesthesia is required. A small incision is made in the back and a nephroscope is passed directly into the kidney. Direct fragmentation of the stone is performed using an ultrasonic, electrohydraulic, or laser device through the nephroscope under direct vision. This treatment can also be performed using the Dornier Medilas H20.
Conservative Treatment – Diet, hydration, medications or a combination of these treatments may assist the natural passing of the calculi. The conservative treatment is only successful for stones smaller than 5 mm in diameter. The effectiveness of medications is dependent on the composition of the stone.
Endoscopic Treatment - The endoscopic treatment, as described using laser lithotripsy, can also be performed using a specialized basket to remove the stone completely. The advantage of Holmium laser lithotripsy over other endoscopic treatments is decreased stone movement and decreased bleeding during treatment.