Surgery is only an option when the stone is a size or shape that will prevent its passage and is blocking the flow of urine, or when it is causing damage to the kidney or another part of the urinary tract. Surgery may also be chosen if a kidney stone attack or serious kidney infection must be prevented (as in airline pilots or kidney transplant recipients). If the stone is very large, or in a spot that would be difficult to treat with ]]>extracorporeal shock wave lithotripsy (ESWL)]]> , your doctor may elect surgical removal of your kidney stones.

Percutaneous Nephrolithotomy

The kidney stone is removed through a small incision in the back.

Description of the Procedure:

Your doctor makes a small (½ inch) incision in your back through to your kidney, inserts a tube called a nephroscope, and uses this tube to remove the stone. A device called a lithotripter may be used to break the stone into smaller pieces for easier removal. After the stone is removed, a small tube called a nephrostomy tube is placed in your kidney while it heals.


A flexible tube is snaked through the bladder into the ureter to retrieve the kidney stone.

Prior to Procedure:

  • Your urine will be tested for infection.
  • Arrange for a ride home after the procedure if a general or spinal anesthetic is planned.
  • Ask your doctor if he or she has any special instructions.

Description of the Procedure:

A small, flexible fiberoptic tube is threaded from the urethra, into the bladder, and up into the ureter. A device passed through the tube is used to retrieve the stone. Sometimes the stone is broken up with a laser before it can be removed. A small plastic tube called a stent may be left in place to hold the ureter open as it heals; this is similar to the type of device used to keep blood vessels open after angioplasty. Your doctor will instruct you on how to watch out for infection.

Open Surgery

In very rare instances, open surgery is required to remove a very large or oddly shaped stone that is obstructing the flow of urine from a kidney.

Description of the Procedure:

An open incision several inches long is made, usually in your flank, to access the kidney and remove the stone. Recovery time is longest with open surgery.