Minimally Invasive Kidney Stone Management
Kidney, ureter and bladder stones (also called calculi) occur when minerals in urine crystallize into small, hard masses that can cause pain, bleeding, obstruction or infection. Urologists at Maine Medical Center were the first to perform kidney stone lithotripsy in the state. Out urologists have developed sophisticated algorithms for the surgical management of urinary stone disease and utilize the latest in technology to improve outcomes in our patients, such as Holmium:YAG laser surgery of urinary tract stones and shock wave lithotripsy (SWL) to treat kidney stones.
Lithotripsy breaks a stone into small particles that can often be passed in the urine. Two types of lithotripsy are available at MMC; their use depends on the size and location of a patient’s stone(s):
- Percutaneous Nephrolithotomy (PCNL)
This is a surgical method used on kidney stones larger than 2 centimeters, or for especially hard stones. Performed under general anesthesia, a small incision is made in the back and a tube called a nephroscope is passed directly into the kidney. The stone is broken into fragments using an ultrasonic, electrohydraulic or laser device inserted through the nephroscope, and the stone fragments are then removed through the tube. Our urologists were the first surgeons in Maine to perform this procedure.
- Ureteroscopic Laser Lithotripsy
This is an outpatient procedure performed under general anesthesia. The urologist inserts a small, flexible tube called an endoscope into the urinary tract to get close to the stone. A small fiber is snaked up the endoscope so that the tip – which emits laser energy – can come in contact with the stone. This intense light energy breaks the stone into increasingly smaller pieces, which can be extracted or flushed out. With this focused type of laser energy, no other tissue is affected. MMC urologists were the first in Maine to offer this advanced treatment.
- Shock Wave Lithotripsy (SWL)
This non-invasive, outpatient treatment uses external shock waves to break a stone into small pieces that can more easily travel through the urinary tract and pass from the body. The patient lies on a water-filled cushion, and the surgeon uses X-rays or ultrasound to precisely locate the stone. High-energy sound waves pass through the patient’s body to break the stone into small pieces which pass through the urinary tract and out of the body.