Kidney Stone Surgery

We offer a full range of minimally invasive procedures to remove kidney stones, including:

• Ureteroscopy laser lithotripsy: This procedure is for smaller stones. It involves inserting a narrow tube equipped with a camera and laser into your urinary tract through your urethra. The surgeon uses the laser to break up the stone and removes the pieces through a separate suction line. This suction device is a recent innovation that helps remove the stone fragments more efficiently and effectively.
• Percutaneous nephrolithotomy: For larger stones, the surgeon inserts instruments into your kidney through your back using image guidance. Difficult-to-treat stones may require the assistance of an interventional radiologist to place the tools precisely. The surgeon then extracts the stone whole or breaks it up with a laser or ultrasound device and suctions out the pieces. Our surgeons use the latest tools to make this procedure safer. Recent advances include ultrasound guidance to lessen radiation exposure and smaller tools to reduce tissue damage.
• Robotic-guided laparoscopic surgery: In laparoscopic procedures, the surgeon inserts narrow instruments through small incisions in your abdomen. We rarely use this approach for kidney stones—typically only for complex kidney anatomy or to remove the entire kidney.

Bladder Stone Surgery

Most bladder stones are too big to pass. To remove bladder stones, surgeons use procedures similar to those for kidney stones:

• Transurethral cystolitholapaxy: This is the most common procedure for bladder stones. It involves inserting a thin tube equipped with a camera and instruments into the bladder through the urethra.
• Percutaneous suprapubic cystolitholapaxy: In this procedure, the surgeon accesses the bladder through a small incision in your lower abdomen.
• Open surgery: Although rare, surgeons may use open surgery (a large incision) for big stones or when it’s not possible to use less invasive methods.

After kidney stone treatment, about 75% of people develop another kidney stone. Our urologists work closely with Stanford Health Care nephrologists (kidney experts) to help patients prevent future kidney stones.

Care typically includes an analysis of the removed kidney stone, in-depth urine testing, and a review of your diet. Your team may recommend medications to prevent another kidney stone. Dietary changes are also important and may depend on the stone type. General dietary recommendations include:

• Drinking 2.5 liters of fluid daily
• Eating more fruits and vegetables
• Getting enough calcium
• Limiting sugar, salt, and protein-rich foods

If you need help changing your diet or have specific dietary needs, your doctor may refer you to the Department of Clinical Nutrition. Our dietitians provide education, customized eating plans, and support to make dietary modifications easier.

Bladder stones can also develop again after treatment. Addressing the underlying cause, such as benign prostatic hyperplasia (BPH), can help prevent new bladder stones. Your doctor may recommend other prevention measures, as well, such as drinking more water, dietary changes, and medications.