ESWL (extracorporeal shock wave lithotripsy) a procedure that uses outside energy to break up the stone. No incisions (cut in the skin) are needed for this surgery.

Before the procedure, a moving X-ray locates the stone, and then the energy waves crush the stone into very small pieces. The small stone pieces pass when the child urinates.

Patients usually go home the same day of the procedure and return to normal activities in one to three days. Your child should not be involved in vigorous physical activity if a ureteral stent is placed to help the stone fragments pass.

Percutaneous Nephrolithotomy
A Nephrolithotomy is used when a very large stone is located in the kidney or when other treatments fail.

During this procedure, a small cut is made in the lower back and a small telescope is inserted into the kidney. Once seen, the stone can be broken into smaller pieces and removed.

This procedure may be needed to prevent kidney damage and infection if something, such as a kidney stone, is blocking normal urine drainage through the ureter (tube connecting kidney to bladder).

Nephrostomy Tube Placement
A Nephrostomy tube is usually placed during the Nephrolithotomy procedure. The tube is placed directly into the kidney through a small opening in the back.

Once the tube is in place, the urine collects in a bag outside the body.

Once the kidney stone or other blockage has been taken care of and the tube is no longer needed, it will be removed (usually 2-3 days).

A Ureteroscopy treatment involves use of a small telescope (ureteroscope) to access stones in the ureter (tube that goes from the bladder to the kidney) or kidney.

No cut in the skin is needed since the scope enters at the urethra (opening which allows urine to exit body), proceeds to the bladder and the ureter.

When the stone is seen it can be removed with a basket-like tool. If the stone is large, a laser can be used to break it into very small pieces.

A Ureteral stent may be placed after the ESWL or ureteroscopy procedures. It may also be placed without any other procedure, to assist the stone to pass down the ureter.

The stent is a thin, flexible tube that extends from the kidney to the bladder. It prevents blockage of urine due to swelling or buildup of stone fragments. The stent cannot be seen from outside the body.

The child may feel some discomfort, and feel the urge to urinate often. The urine may appear pink or red. These symptoms will disappear when the stent is removed several weeks later.

Antibiotics and a medication to stop bladder spasms (from irritation of the bladder wall by the stent) will be prescribed. Contact sports and physically strenuous activities must be avoided.