$Unique_ID{BRK00069}
$Pretitle{Genitourinary System}
$Title{Surgery for Kidney Stones}
$Subject{stones kidney surgery}
$Volume{J-16}
$Log{
Normal Kidney*0004801.scf
Multiple Small Calculi (Stones)*0004802.scf
Stag-horn Calculus (Stone)*0004803.scf
Passage of a Stone*0004804.scf}

Copyright (c) 1991   Tribune Media Services, Inc.


Surgery for Kidney Stones


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QUESTION:  Is it always necessary to be operated on for kidney stones?

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ANSWER:  Well, let me begin by telling you of my experience.  Ralph had become
a statistic, as well as my patient.  He had become one out of each eight men
in this country, who by the age of 70, will develop a kidney stone.  He came
to me in distress and pain.  A while back, he would have had two choices;
either he would have been able to pass the stone or invasive, open surgery
would have been performed.  Of course, surgery was and still is dictated by
some hard and fast rules.  The first is the size of the stone and its ability
to be passed.  Usually stones smaller than 4 mm. have a 75% change of being
passed.  Other criteria are persistent pain or bleeding, partial obstruction,
chronic infection, and stones increasing in size.  Well, Ralph had all these
symptoms, but as a doctor practicing medicine in 1988, I had at my disposal
three non-invasive techniques for the elimination of kidney stones, which I
explained to Ralph.
     The first technique is called PNL (percutaneous nephrolithotomy) and
involves the use of a needle to gain access to the kidney.  A contrasting dye
is instilled into the urinary tract to gain knowledge of the location of
stones, and then the tract is dilated and removal is accomplished through
forceps.  This procedure is not for patients with bleeding problems or those
who have hypersensitivity to the contrast medium.  A second procedure is
called ureteroscopy and involves the use of a ureteroscope; this procedure is
for stones located in the ureter.  The most recent procedure is ESWL
(extracorporeal shock-wave lithotripsy), a method first used in Germany in
1980 and approved by the FDA for use in this country in 1984.  This method
uses shock waves, which break the stone into small sand-like particles, which
the patient will pass in the next two- to three-week period.
     So, though Ralph was a candidate for removal of his kidney stones, he did
not need open surgery.  We discussed the best method for him and he was spared
the lengthy hospitalization, the increased risk, and the drain on his
finances.  What these three methods have in common are a good success rate,
and the ability to make a patient as good as new in a short period of time.
ÿ
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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
