Urinary Stone Treatment
Advanced Treatment for Kidney Stones and Bladder Stones
One in every 10 Americans will develop urinary stones in their lifetimes. Often, these kidney stones and bladder stones will pass naturally through the urine with little discomfort. But at other times, the pain from a kidney stone or bladder stone can be sudden and excruciating. During those times, it’s critical to find expert kidney stone care close by. If you live in northwestern, central or southwestern Pennsylvania, Penn Highlands Healthcare is here to provide state-of-the-art care for kidney stones and bladder stones.
Kidney Stone Treatment Using the Latest Technology
As kidney stones and bladder stones become more common in the United States, Penn Highlands urologists are answering the call by adding treatments that are less invasive and more effective. Our urologists are experts in managing kidney stones first with medicines and other non-invasive treatments to help patients pass stones in their urine. If those treatments don’t work, our urologists use noninvasive lithotripsy shock waves to break down stones small enough to pass on their own. For larger stones, Penn Highlands urologists use the latest technology called MOSES holmium laser to break up the stones so they can be removed in minimally invasive same-day surgery.
Kidney Stones vs Bladder Stones
Kidney stones and bladder stones are hardened masses of minerals and salts in your urine. While both types of stones are formed by concentrated urine, they form for different reasons. Kidney stones are the most common type of urinary stone and include stones found in the kidney and the ureter. About 11% of men and 6% of women in the US will develop a urinary stone in their lifetime, according to the US Department of Health and Human Services. Of those, only about 5% will form in the bladder, most commonly affecting men over age 50 due to a link with enlarged prostates. Kidney stones also can be found in the ureter and occasionally, although rarely, a kidney stone can pass into the bladder.
Although kidney stones and bladder stones are formed differently, they both involve a concentration of urine so the first treatment is to drink at least 6 to 8 glasses of water to see if that can break down the stone enough for it to pass on its own. Because most people who experience stones will get them again, drinking adequate amounts of water daily also helps prevent future stones.
Treatment Options at Penn Highlands:
- Kidney Stone Treatment
- Bladder Stone Treatment
- Ureter Stone Treatment
- Lithotripsy
- Moses Laser
- Percutaneous Nephrolithotomy
- PCNL Surgery
Urology
Penn Highlands Urology - DuBoisA Service of Penn Highlands DuBois
Urology
Penn Highlands Urology - ClearfieldA Service of Penn Highlands DuBois
Penn Highlands Urology - DuBoisA Service of Penn Highlands DuBois
Treating Kidney Stones That Don’t Pass Naturally
Kidney stones that are smaller than 4 millimeters typically pass on their own within about a month. Stones larger than that usually need some type of medical treatment. Penn Highlands urologists offer expert kidney stone treatments based on the size and location of the kidney stone and also whether it is obstructing the urine flow (which requires more immediate intervention).
Kidney stones that need medical treatment are those that do not pass on their own and are causing:
- Pain
- Bleeding
- Impaired urine flow
- Urinary tract infections
- Damage to kidney, ureter or bladder tissue
Urologists use several methods for removing kidney stones, beginning whenever possible with the least invasive treatments. At Penn Highlands, our urologists offer noninvasive treatments that don’t require surgery and minimally invasive surgery where the patients can go home the same day. If needed due to the size or location of the stone or the health of the patient, some patients may need to stay in the hospital for kidney stone surgery.
Extracorporeal Shock Wave Lithotripsy (ESWL)
Extracorporeal shock wave lithotripsy (ESWL) is a noninvasive procedure that uses safe, high-energy sound waves to break kidney stones into tiny pieces. Using a lithotripter, the urologist aims these waves, also called shock waves, at the kidney from outside the body. Once the stones are broken up, they can more easily pass.
The urologist also may place a ureteral stent at the same time as the lithotripsy to ensure that the pieces of the stone don’t get lodged in the ureter and block urine flow. A ureteral stent is a thin, flexible tube that is placed inside the ureter to hold it open so that stone fragments can pass.
Lithotripsy can be performed in about an hour. Depending on the patient, it may be performed in a clinic or hospital as a same-day procedure or you may need to stay in the hospital for a day or two.
MOSES™ Holium Laser Lithotripsy
Like ESWL, laser lithotripsy is used to break up kidney stones, but it is typically used for larger stones that need surgical intervention. It also is used to break up bladder stones and kidney stones that have moved into the ureter or urethra.
A urologist performs this minimally invasive procedure during a ureteroscopy. The urologist will insert a small tube called a ureteroscope with a tiny camera on the end through the urinary tract into the kidney. Using the ureteroscope the urologist then threads a flexible laser fiber into your kidney and directs highly focused beams of light, called radiant energy, to break up the stones.
Once the stones have been broken up, the urologist removes the pieces with a small basket or other instruments that are also inserted through the ureteroscope. Because the scope has been threaded through your urinary tract, there are no incisions.
Sometimes, however, extremely large stones or misshapen stones (called staghorn kidney stones) cannot be broken into pieces small enough to be removed through the ureteroscope. In these cases, the urologist will remove the pieces of stone during percutaneous nephrolithotomy (PCNL), a minimally invasive surgery performed through a small incision in your back.
At Penn Highlands, urologists use the latest holium laser technology, called Moses. This technology uses a specialized laser pulse to first separate the liquid around the stone so that the energy can be applied directly to the target. Moses was shown in a clinical study to be more efficient than standard laser lithotripsy, resulting in shorter treatment times. It also decreases a phenomenon called retropulsion that occurs when the laser energy pushes the stone into a different position. If that happens the surgeon must relocate the stone, and if it has been pushed into a hard-to-reach position, a second surgery may be required.
With the use of the Moses technology, Penn Highlands urologists are now able to remove urinary stones via ureteroscopy or PCNL during same-day procedures for 90% of patients. This means patients can go home the same day as the procedure and are also able to have the catheter removed that day or the next in the doctor’s office.
Percutaneous Nephrolithotomy (PCNL) Surgery
PCNL is a surgery to remove very large kidney stones that cannot be broken up with laser small enough to be removed via ureteroscopy. These stones are often 10-15 cm or larger. PCNL is used to remove staghorn kidney stones.
PCNL is a minimally invasive surgery, which means the surgeon performs it through instruments inserted into the patient’s body through small incisions. Although it is minimally invasive, it does require hospitalization.
The urology surgeon will first use laser lithotripsy to break up the stone into smaller parts. Then the surgeon will perform PCNL to reach the kidney through a small incision in your back to remove the pieces of stone. In nine out of 10 cases, patients can go home the same day as the procedure.
This same procedure is used to treat bladder stones. On the morning of the procedure, an interventional radiologist will place a suprapubic tube (SPT) into the bladder through a small hole in the lower abdomen. Later that day, the urology surgeon will break the stone into smaller pieces with the Moses laser and then remove those pieces via PCNL surgery into the bladder. The surgeon also will place a temporary ureteral stent to drain urine from the kidney into a bag outside of the body, bypassing the ureter and bladder so that any additional fragments or stones that aren’t seen during the procedure can pass.
