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Treatments for Large Kidney Stones

Some kidney stones are too large to pass through the urinary system and may cause painful symptoms or even urinary tract infections. In this case, your doctor may recommend surgical procedures that include:

  • Percutaneous nephrolithotomy (PCNL) is an innovative surgical treatment for patients who have large, complex kidney stones that cannot be treated successfully using other treatments.  Typically, PCNL is used to remove kidney stones that are larger than 2cm in diameter and cannot be passed through the urinary tract. Percutaneous refers to surgery via a small incision through the skin, rather than an open, more invasive procedure. PCNL has become a viable and preferred alternative to open surgery for removing large kidney stones and should be performed by a highly trained surgeon who has specific experience with this complex, delicate procedure.
  • Shockwave lithotripsy (SWL) utilizes an X-ray machine to locate the stone(s) within the body, and shock waves are used to break up the stone(s) into very small particles that can be passed through the urine. This procedure is the least invasive option –  there are no incisions and no scopes placed into the patient’s body.  SWL, however, may not be appropriate for all patients as the shock waves may not adequately break up stones in certain cases.
  • Ureteroscopy/ Renoscopy uses a small scope that is passed into the body through the urethra (the tube where urine exits the body) without the need for an incision.  The scope is then advanced to the kidney stone and a laser is used to break it up. This option is appropriate for nearly all stones; however, with larger stones repeat procedures may be necessary to completely clear them.
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