Urinary tract stones that are not amenable to conservative management, can be treated by the following techniques
ESWL (link to ESWL article)
A ureteroscopy is done with a ureteroscope, a semi-rigid long, thin viewing tube that has tiny lens and a light one end. In general, there are two ways to perform ureteroscopy for stones:
Ureteroscopy is usually done on a day surgery basis under general anaesthesia.
There is a small chance of infection, bleeding, or injury to the ureter. lf the ureter is too small, a stent may be left in place for one or two weeks to keep the ureter open and then the procedure is performed at a later date.
Retrograde intrarenal surgery (RIRS) is a procedure for doing surgery within the kidney using a flexible ureteroscope.
In RIRS the scope is placed through the urethra (the urinary opening) into the bladder and then through the ureter into the urine-collecting part of the kidney. The scope thus is moved retrograde (up the urinary tract system) to within the kidney (intrarenal).
RIRS may be done to remove a stone. The stone is seen through the scope and can then be fragmented by a laser fibre or removed by small forceps or baskets.
The procedure is usually done under general anesthesia, as a day surgery procedure or with an overnight stay.
These include :
Percutaneous nephrolithotomy (PCNL) is a procedure used to remove kidney stones from the body when they can't pass on their own. A scope is inserted through a small incision in your back to remove the kidney stones.
PCNL is used most often when kidney stones are too difficult to reach, too large, too numerous, or too dense to be treated by shock wave lithotripsy or ureteroscopy.
The most common risks from percutaneous nephrolithotomy include the following:
A video that illustrates this procedure can seen here: