Percutaneous Nephrolithotomy
A surgical treatment option used to safely remove large, infected, or hard-to-reach kidney stones that will not pass in their own.
Kidney Stones
We focus on removing stones completely and preventing their return
Kidney stones are pieces of solid, crystallized matter that form in the kidneys. These stones develop when chemicals that are normal in the urine become concentrated.
Kidney stones are a common urinary tract disorder, affecting approximately 10 percent of people at some point in life.
Fortunately, kidney stones are highly treatable and usually do not cause permanent damage, although they can be painful. The physicians at IU Health remove your kidney stones if necessary, identify their cause and help you prevent new ones from forming.
What are Symptoms of Kidney Stones?
Kidney stone symptoms include:
- Pain while urinating
- Sharp pain in the lower back or lower abdomen
- Blood in the urine
- Nausea
- Vomiting
- Fever
- Abnormal urine color or odor
What are Risk Factors for Kidney Stones?
Kidney stones occur most often in people ages 20 to 50, and they affect more men than women. Most kidney stones are made of calcium. Others contain cystine, struvite or uric acid. It is not always clear why they form. Risk factors for kidney stones include:
- Family history of kidney stones
- Drinking too few fluids
- Urinary tract blockage
- Obesity
- Gastrointestinal surgery
- Hypercalciuria (condition in which the urine contains too much calcium)
Some kidney stones are small and pass out of the body without causing symptoms. Imaging techniques, such as X-ray, ultrasound and computed tomography (CT), can detect stones in patients with or without symptoms.
Most kidney stones exit the body on their own. Others become trapped in the ureter (tube that runs from the kidney to the bladder), where they can cause pain and even kidney damage.
We find the reason for your kidney stones and develop an individualized plan to manage them.
Understanding Kidney Stones
What are Symptoms of Kidney Stones?
Kidney stone symptoms include:
- Pain while urinating
- Sharp pain in the lower back or lower abdomen
- Blood in the urine
- Nausea
- Vomiting
- Fever
- Abnormal urine color or odor
What are Risk Factors for Kidney Stones?
Kidney stones occur most often in people ages 20 to 50, and they affect more men than women. Most kidney stones are made of calcium. Others contain cystine, struvite or uric acid. It is not always clear why they form. Risk factors for kidney stones include:
- Family history of kidney stones
- Drinking too few fluids
- Urinary tract blockage
- Obesity
- Gastrointestinal surgery
- Hypercalciuria (condition in which the urine contains too much calcium)
Some kidney stones are small and pass out of the body without causing symptoms. Imaging techniques, such as X-ray, ultrasound and computed tomography (CT), can detect stones in patients with or without symptoms.
Most kidney stones exit the body on their own. Others become trapped in the ureter (tube that runs from the kidney to the bladder), where they can cause pain and even kidney damage.
We find the reason for your kidney stones and develop an individualized plan to manage them.
Our treatment of kidney stones focuses on two goals:
- Removing stones completely
- Preventing their return
We remove kidney stones if they are causing pain or damaging your kidneys. Complete removal is important because remaining stones or fragments can cause new crystals to grow in the kidneys.
How are Kidney Stones Removed?
Kidney stone removal options include:
Extracorporeal Shockwave Lithotripsy (ESWL)
This treatment involves using sound waves from outside the body to break up kidney stones. It is a nonsurgical procedure that breaks kidney stones into tiny pieces by sending shock waves (high-energy sound waves) through your body. The shock waves do not harm the kidneys, but they break the kidney stones into tiny pieces.
These pieces can then be passed out of your body with your urine, or they can be removed through a tube placed at the outlet of the kidney where urine flows into the ureter (tube that leads from the kidney to the bladder). You typically go home soon after the procedure is completed.
Ureteroscopy
As the most common kidney stone treatment option, IU Health is a leader in providing ureteroscopy procedures. A ureteroscopy is a minimally invasive treatment done in an outpatient setting. This procedure is suitable for patients of all sizes, body types and lifestyles, including those who are on blood thinners or pregnant.
A ureteroscope allows a tiny camera and instruments to be inserted through the urethra to the place where a kidney stone is lodged in the kidney or ureter. We can see on a monitor live images of the ureter and the stone, allowing us to break up the stone safely with an advanced laser.
The pieces of the stone pass out into the bladder and are then eliminated through urination. This nonsurgical technique allows you to leave the hospital usually on the same day and return to normal activities in a few days to a week.
Percutaneous Kidney Stone Removal
Large stones may need to be removed with a minimally invasive surgical procedure called percutaneous nephrolithotomy. In this procedure, we make a small incision in your back and insert a tube that allows us to use small tools inside the body.
We remove the stone through the tube or break it up and allow it to pass out of your body in urine. To help the broken stone material pass through the ureter, we can place a stent (a tube that holds the ureter open) in it to make it wider. We remove the stent in a few days after we are sure all the stone fragments have passed out of the body.
Why Choose IU Health for Kidney Stone Treatment
IU Health provides some of the best kidney stone treatment in the world:
- We brought extracorporeal shockwave lithotripsy (ESWL—using sound waves from outside the body to break up kidney stones) to the U.S. nearly 30 years ago.
- Around the same time, we also performed the first percutaneous (through a tube inserted into a small incision) kidney stone removal in the region.
- We have developed advanced methods for removing kidney stones that enable our experts to perform the entire procedure. Previously it was necessary in some procedures to have a specially trained radiologist begin the procedure, which was then finished by a urologist. At IU Health, our specialists are trained to perform the entire procedure, reducing the risk of complications and providing a better patient experience.
If you have had kidney stones, you may be at risk of developing more stones in the future. Our experienced nephrologists, urologists, nurses and other team members manage kidney stones based on their type and cause.
We use your medical history along with blood tests and specialized urine studies to find the reason for your problem. For most patients, dietary changes and medicine can stop kidney stones or reduce their frequency.
Through our close relationship with Indiana University School of Medicine, we offer the most innovative options for preventing kidney stones.
How Can I Prevent Kidney Stones?
Preventing kidney stones requires an individualized plan based on the type of stones you have and the reason for the condition. Services and options related to kidney stone prevention include:
Assessment
To help you reduce the chance of future kidney stones, we must first find the reason you are prone to developing them. We perform a thorough medical, nutritional and lifestyle evaluation to find out why you have kidney stones. Our assessment includes analysis of your kidney stones, blood and urine.
Medicine
We prescribe a variety of medicines based on the cause and type of your kidney stones. This approach works only when we know the reason for the problem. For example, if your stones are caused by hypercalciuria, we may give you diuretics, such as hydrochlorothiazide. For cystine stones, we may prescribe mercaptopropionyl glycine to decrease cystine in the urine.
Dietary changes
We recommend a specific diet depending on the type of kidney stones you have. For example, for calcium oxalate stones, you need to cut back on sodium, animal protein and foods high in oxalate, such as rhubarb and nuts.
For uric acid stones, you need to reduce animal protein. Drinking plenty of fluids, especially water, also helps to prevent most types of kidney stones. The recommendation is often two to three liters of fluid per day, or even more for cystine stones.
What are Treatment Options for Kidney Stones?
Our treatment of kidney stones focuses on two goals:
- Removing stones completely
- Preventing their return
We remove kidney stones if they are causing pain or damaging your kidneys. Complete removal is important because remaining stones or fragments can cause new crystals to grow in the kidneys.
How are Kidney Stones Removed?
Kidney stone removal options include:
Extracorporeal Shockwave Lithotripsy (ESWL)
This treatment involves using sound waves from outside the body to break up kidney stones. It is a nonsurgical procedure that breaks kidney stones into tiny pieces by sending shock waves (high-energy sound waves) through your body. The shock waves do not harm the kidneys, but they break the kidney stones into tiny pieces.
These pieces can then be passed out of your body with your urine, or they can be removed through a tube placed at the outlet of the kidney where urine flows into the ureter (tube that leads from the kidney to the bladder). You typically go home soon after the procedure is completed.
Ureteroscopy
As the most common kidney stone treatment option, IU Health is a leader in providing ureteroscopy procedures. A ureteroscopy is a minimally invasive treatment done in an outpatient setting. This procedure is suitable for patients of all sizes, body types and lifestyles, including those who are on blood thinners or pregnant.
A ureteroscope allows a tiny camera and instruments to be inserted through the urethra to the place where a kidney stone is lodged in the kidney or ureter. We can see on a monitor live images of the ureter and the stone, allowing us to break up the stone safely with an advanced laser.
The pieces of the stone pass out into the bladder and are then eliminated through urination. This nonsurgical technique allows you to leave the hospital usually on the same day and return to normal activities in a few days to a week.
Percutaneous Kidney Stone Removal
Large stones may need to be removed with a minimally invasive surgical procedure called percutaneous nephrolithotomy. In this procedure, we make a small incision in your back and insert a tube that allows us to use small tools inside the body.
We remove the stone through the tube or break it up and allow it to pass out of your body in urine. To help the broken stone material pass through the ureter, we can place a stent (a tube that holds the ureter open) in it to make it wider. We remove the stent in a few days after we are sure all the stone fragments have passed out of the body.
Why Choose IU Health for Kidney Stone Treatment
IU Health provides some of the best kidney stone treatment in the world:
- We brought extracorporeal shockwave lithotripsy (ESWL—using sound waves from outside the body to break up kidney stones) to the U.S. nearly 30 years ago.
- Around the same time, we also performed the first percutaneous (through a tube inserted into a small incision) kidney stone removal in the region.
- We have developed advanced methods for removing kidney stones that enable our experts to perform the entire procedure. Previously it was necessary in some procedures to have a specially trained radiologist begin the procedure, which was then finished by a urologist. At IU Health, our specialists are trained to perform the entire procedure, reducing the risk of complications and providing a better patient experience.
If you have had kidney stones, you may be at risk of developing more stones in the future. Our experienced nephrologists, urologists, nurses and other team members manage kidney stones based on their type and cause.
We use your medical history along with blood tests and specialized urine studies to find the reason for your problem. For most patients, dietary changes and medicine can stop kidney stones or reduce their frequency.
Through our close relationship with Indiana University School of Medicine, we offer the most innovative options for preventing kidney stones.
How Can I Prevent Kidney Stones?
Preventing kidney stones requires an individualized plan based on the type of stones you have and the reason for the condition. Services and options related to kidney stone prevention include:
Assessment
To help you reduce the chance of future kidney stones, we must first find the reason you are prone to developing them. We perform a thorough medical, nutritional and lifestyle evaluation to find out why you have kidney stones. Our assessment includes analysis of your kidney stones, blood and urine.
Medicine
We prescribe a variety of medicines based on the cause and type of your kidney stones. This approach works only when we know the reason for the problem. For example, if your stones are caused by hypercalciuria, we may give you diuretics, such as hydrochlorothiazide. For cystine stones, we may prescribe mercaptopropionyl glycine to decrease cystine in the urine.
Dietary changes
We recommend a specific diet depending on the type of kidney stones you have. For example, for calcium oxalate stones, you need to cut back on sodium, animal protein and foods high in oxalate, such as rhubarb and nuts.
For uric acid stones, you need to reduce animal protein. Drinking plenty of fluids, especially water, also helps to prevent most types of kidney stones. The recommendation is often two to three liters of fluid per day, or even more for cystine stones.
