Stones in the kidneys are formed from the dietary minerals contained in the urine. They are classified based on the location where they are found. Small stones formed in the kidneys naturally pass out during urination without being noticed. Stones with a size of 3 mm or more usually get struck in the kidney or bladder or ureter causing severe pain. The surgical procedure followed by surgeons to remove stones trapped inside the ureter is known as ureterolithotomy. Ureter is the tube connecting the kidney and the bladder.
Acute pain in the flanks which radiates to abdomen and groin area is the most common and important symptom of kidney stones. This pain may be followed by fever, nausea, vomiting, blood in urine etc.
Symptoms shown by the patient and a physical examination by the physician will be enough for preliminary diagnosis. For confirming preliminary diagnosis and for finding the exact location, size and number of stones, the surgeon may ask the patient to undergo diagnostic tests like urinalysis, ultrasonic scanning, blood tests etc.
Treatment for kidney stone starts with medications to control the pain. When pain is reduced doctor may ask the patient to wait for some time to get the stones passed out through urination in the natural way. If symptoms persist, methods like shock wave lithotripsy in which ultrasonic or shock waves are directed on the stones. These waves pulverise the stones and the powdered stone particles are drained out through urination. If none of the above treatments produce any relief, then your surgeon may suggest that the stones may be removed through a surgical procedure.
This procedure is generally done under general anaesthesia. In the open surgery, through a large incision the surgeon directly access the target area, cuts the urethra using his hands and takes the stone out and removes it outside the body.
Ureterolithotomy can be done as a laparoscopic procedure also which means that the surgery is carried out by the surgeon using special instruments controlled by him seeing the videos of the organs in the surgery site in a monitor with the help of laparoscope. For this purpose only two or three small incisions of the size 1 to 2 cms are needed. Laparoscope is an instrument with a camera on top of a long flexible tube which is inserted through one of the small cuts and other instruments for surgery are inserted through the remaining small incisions. After removing the stones the incisions are closed by suturing.
- Only small incisions are needed in this surgery, which reduces the blood loss and consequently blood transfusion is not necessitated
- Less healing time faster recovery and earlier return to normal life
- Smaller incisions make smaller scars and it has a better aesthetic effect.
- Obese persons and person with high blood pressure etc are not suitable for this type of surgery.
Persons who have earlier undergone a surgery in the target area are not suitable for laparoscopic surgery.
Dr. Nagaraj B Puttaswamy
Senior Consultant - Laparoscopic Surgeon Bariatric Surgeon and Surgical Gastroenterologist