Procedures for Kidney Stones

Before undergoing surgery for kidney stones, Dr. Farag will ensure that the procedure is safe and tailored to your needs. This involves several preoperative tests and assessments:

• Medical history and examination: Review of your overall health, medications, previous surgeries, and any existing medical conditions.

• Blood tests: To check kidney function, blood count, and general health.

• Urine tests: To check for infection or blood. If an infection is found, this must be treated prior to the surgery.

• Imaging: Scans such as ultrasound, CT, or X-ray to locate the stone and plan the best surgical approach.

• Pre-anaesthetic assessment

• Medication review: Some medications, such as blood thinners, may need to be paused or adjusted prior to surgery.

You will also receive instructions on fasting, medications, and what to expect on the day of surgery, helping reduce risks and support a smooth recovery.

On the day of your procedure, you will arrive at the hospital a few hours before your scheduled surgery. After check-in, the nursing team will guide you through routine preoperative checks.

You will meet Dr. Farag and your anaesthetist, who will confirm the procedure, answer any final questions, and explain what to expect. A small intravenous (IV) line will be placed. You will then be taken to the operating theatre and given an anaesthetic, so you will be comfortable throughout the procedure.

The type of procedure will depend on your stone’s size and location:

• Ureteroscopy (URS): A thin telescope is inserted through the urethra and bladder to remove or break up the stone.

• Shock Wave Lithotripsy (ESWL): Focused sound waves are used to break the stone into smaller pieces that can pass naturally.

• Percutaneous Nephrolithotomy (PCNL): A small incision in the back allows direct removal of larger stones from the kidney.

• Robotic or other surgical procedures: Used for larger or complex stones in selected cases.

After surgery, you will wake up in the recovery area, where your vital signs and comfort will be closely monitored. You may have a urinary catheter or temporary stent in place. Pain is usually well controlled with medication. You will be encouraged to start moving and drinking fluids as soon as it is safe.

Dr.Farag will review your progress, explain how the procedure went, and guide you through the next steps in your recovery.

A ureteric stent (also called a ureteral stent) is a thin, flexible tube placed in the ureter, the tube that connects your kidney to your bladder. The stent helps urine flow safely from the kidney to the bladder, bypassing any obstruction. Most stents are made of soft plastic and are usually temporary.

Why a Stent Might Be Needed

Ureteric stents are commonly used in patients with kidney stones for several reasons:

• Pain from a stone: If a stone blocks urine flow, it can cause significant pain and back pressure on the kidney.

• Infection: When a stone is associated with infection, a stent allows urine to drain and reduces the risk of complications.

• After surgery: Following stone removal, a stent helps prevent blockage from blood, debris, or swelling.

Possible Stent Symptoms

While stents are very helpful, they can sometimes cause mild discomfort, including:

• Increased urinary frequency and urgency

• Occasional blood in the urine

• Flank or kidney discomfort

Removal of the Stent

Stents are usually temporary and are removed once the kidney stones have been treated. Removal is typically done using a flexible cystoscope, which can be performed under local anaesthetic or sedation, making the process quick and well-tolerated.

Recovery after kidney stone surgery depends on the type of procedure and your overall health, but most patients can expect a gradual return to normal activities over days to weeks.

Hospital Stay

• Ureteroscopy (URS) or ESWL: Usually same-day discharge or an overnight stay.

• Percutaneous Nephrolithotomy (PCNL) or complex surgery: Typically 1–3 days in hospital.

Early Recovery at Home

• Pain and discomfort: Mild to moderate pain is common and usually managed with paracetamol or anti-inflammatory medication.

• Activity: Light activity and walking are encouraged immediately. Avoid heavy lifting or strenuous activity for 1–2 weeks after smaller procedures and 4–6 weeks after more complex surgery.

• Hydration: Drink plenty of water to help pass stone fragments and prevent new stones.

• Urinary changes: If you have a stent, you may experience urgency, frequency, or mild discomfort, which usually improves once the stent is removed.

Follow-Up

• Dr.Farag will schedule a follow-up appointment to check recovery, remove stents if present, and review imaging to ensure all stones have been cleared.

• You may need repeat imaging or urine tests to monitor for new stones or complications.

Returning to Normal Activities

• Most patients can return to light work or normal daily activities within 1–2 weeks after minor procedures.

• Strenuous activity, heavy lifting, or contact sports should generally be avoided for 4–6 weeks, or as advised by your surgeon.

While kidney stone surgery is generally safe and effective, all procedures carry some risk. Most patients recover without serious complications, but it’s important to be aware of potential side effects.

Common or Mild Side Effects

• Pain or discomfort at the surgical site or in the kidney area

• Blood in the urine for a few days after surgery

• Urinary frequency or urgency, especially if a stent is in place

• Mild nausea or fatigue after anesthesia

Less Common Risks

• Infection: Urinary tract infections can occur and may require antibiotics

• Bleeding: Usually minor, but rarely may require transfusion

• Stent-related discomfort: Stents can cause urinary urgency, frequency, or flank pain

• Incomplete stone removal: Occasionally, fragments remain and may require further treatment

Rare Risks

• Injury to the ureter or kidney: Very uncommon but may require further surgery

• Severe bleeding or clot formation

• Reactions to anesthesia

• Urine leakage at the site where the kidney or ureter was accessed

Procedure-Specific Considerations

• URS (ureteroscopy): Rare risk of ureteral injury or stricture

• ESWL (shock wave therapy): Small risk of bruising, bleeding, or incomplete stone fragmentation

• PCNL (percutaneous nephrolithotomy): Higher risk of bleeding, infection, or injury due to the incision into the kidney

• Robotic or complex surgery: Used only in selected cases; risks depend on the complexity and patient health

Dr. Farag will arrange the necessary follow-up required. Usually a follow-up X-ray or CT scan is needed to ensure that all the stones have been successful removed.

• Most patients are seen within 1–2 weeks after surgery, then as needed based on results.

• For patients prone to recurrent stones, follow-up may continue periodically over months to years.