What are Nephrolithotomy and Nephrolithotripsy?

Nephrolithotomy and nephrolithotripsy are surgical treatments for large stones that have formed in the kidney, or in the tubes connecting the kidney to the bladder (called the ureters). For these procedures, the surgeon makes an incision in the patient's back and then inserts a tube with a camera, called a nephroscope, into the incision. The nephroscope allows her to see inside the kidney and helps her determine whether the stone is small enough to fit through the tube, or if it needs to be broken up into smaller pieces before removal.

If the surgeon simply takes the stone out using the nephroscope, the procedure is called nephrolithotomy. However, if the stone is very large, the surgeon may use high-frequency sound waves to crush the stone first, and then suction out the stone fragments. This type of kidney stone removal is called nephrolithotripsy.

Before the development of minimally invasive techniques, nephrolithotomy required a long incision, but now it is performed with a cut shorter than half an inch. When the procedure is done this way, it is called percutaneous nephrolithotomy. In contrast, nephrolithotripsy has always been performed through a small incision.

Both percutaneous nephrolithotomy and nephrolithotripsy take approximately 20 to 45 minutes to perform and require a hospital stay of about two or three days. After the stones are removed, you will have two temporary drain tubes -- a nephrostomy, which drains urine from the kidney, and a urinary catheter, which drains urine from your bladder. These tubes will be removed before you get discharged from the hospital. Strenuous activities, including pushing, pulling, and lifting, must be avoided for up to a month, but you may return to work a week after surgery.

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