Kidney stone removal surgery is usually something people only start looking into after weeks of pain, waiting to see if a stone will pass on its own. For many Australians, a small stone does move through the urinary system without any procedure at all. But when a stone is too large, is blocking urine flow, or is causing an infection, surgery becomes the safer path forward.
This article explains, in plain terms, when non-surgical treatment isn’t enough and what kidney stone removal surgery generally involves. It is general information only, and not a substitute for advice from your GP or a specialist surgeon about your own situation. If you have severe pain, a fever, or you’re unable to urinate, this could be a medical emergency, so call 000 or go to your nearest emergency department.
When Does a Kidney Stone Need Surgery?
Many kidney stones, particularly smaller ones, pass naturally over a few weeks with pain relief and plenty of fluids. Your GP may monitor things with scans and urine tests before considering anything more.
Surgery is usually considered when a stone is too large to pass, is blocking urine flow, or has led to infection or severe pain that won’t settle with medication.
You can read general information on how kidney stones form and when they’re treated on healthdirect, a free government health information service.
If your GP feels surgery may be needed, they will typically refer you to a urologist, a specialist surgeon who treats conditions of the urinary system, for further assessment.
The Main Types of Kidney Stone Removal Surgery
There are three main surgical approaches used in Australia, and the right one depends on the size, position and type of your stone.
Shockwave Lithotripsy
This non-invasive option uses focused sound waves, aimed from outside the body, to break a stone into smaller pieces that can then pass more easily on their own.
Ureteroscopy
A thin scope is passed through the urethra and bladder to reach the stone, often combined with a laser to break it up or a small basket to remove it. This is usually done as day surgery.
Percutaneous Nephrolithotomy
For larger or more complex stones, a small incision is made in the back to remove the stone directly. This approach is more involved and usually means an overnight hospital stay.
Your urologist will discuss which of these kidney stone removal surgery options suits you, based on your imaging. Surgeons performing them in Australia are typically RACS-accredited specialist surgeons.
What Happens on the Day of Your Procedure
Most kidney stone procedures are done as day surgery, though some, like percutaneous nephrolithotomy, usually involve at least one night in hospital.
Beforehand, you’ll usually attend a pre-admission clinic to check your general health, and go through an informed consent process so you understand the procedure and its risks.
You’ll also typically meet an anaesthetist to discuss the anaesthesia suited to your procedure, whether that’s a general anaesthetic or lighter sedation.
Your surgeon’s rooms should also give you clear informed financial consent, meaning a written idea of expected costs, before your admission date.
Recovering After Kidney Stone Surgery
Recovery time varies depending on the procedure. Ureteroscopy and lithotripsy usually involve a quicker return to normal activities, while percutaneous procedures often need a longer, gentler recovery.
Mild discomfort and some blood in the urine for a short time afterwards are common. Drinking plenty of water is usually encouraged unless your surgeon tells you otherwise.
Some people benefit from a follow-up with their GP as part of post-operative recovery. Most return to daily activities within a few days to a couple of weeks, depending on the procedure.
Risks and Signs You Should Seek Urgent Care
As with any surgery, kidney stone removal carries some risks, including infection, bleeding, or discomfort from a temporary stent if one is placed to help drainage.
Your surgeon will talk you through the risks relevant to your procedure as part of the informed consent process, so you can ask questions beforehand.
Contact your doctor promptly, or seek urgent care, if you notice any of the following after your procedure:
- Fever or chills
- Worsening pain that isn’t relieved by your prescribed medication
- Heavy or persistent blood in your urine
- Difficulty passing urine, or being unable to urinate at all
- Nausea or vomiting that won’t settle
Reducing Your Risk of Future Kidney Stones
Once a stone has been treated, many people want to know how to lower their chance of another. Staying well hydrated is generally considered helpful, and your GP may suggest lifestyle or dietary adjustments based on the type of stone you had.
Kidney Health Australia has further general information on habits that may help reduce the risk of new stones forming, which is worth discussing with your GP for advice specific to you.
Medicare, Private Health Insurance and Choosing a Surgeon
Kidney stone removal surgery can be performed in either the public or private system. In the public system, it’s usually accessed through the elective surgery waitlist after a specialist referral.
Medicare typically provides a rebate towards eligible specialist and hospital costs, while private health insurance may cover admission to a private hospital, subject to your policy and any applicable waiting periods.
It’s worth checking your fund’s waiting periods and any excess before booking. The government’s privatehealth.gov.au website explains how private health insurance interacts with surgery costs in more detail.
When choosing a surgeon for kidney stone removal surgery, many people look for relevant experience and appropriate accreditation, and feel comfortable asking questions about the recommended approach.
Conclusion
Most kidney stones pass on their own, but when they don’t, there are several established surgical options, from shockwave lithotripsy to ureteroscopy to percutaneous procedures, each suited to different stone sizes and positions. Your GP or urologist will help work out which approach, if any, fits your circumstances.
If you think you may need kidney stone removal surgery, a good first step is talking to your GP about a referral to a urologist. From there, you can compare specialist surgeons across Sydney, Melbourne, Brisbane, Perth, Adelaide and beyond through surgery.com.au to help find the right fit for your care.
FAQs
1. Is kidney stone removal surgery painful?
Most procedures are performed under anaesthesia, so you won’t feel pain during the surgery itself. Some mild discomfort afterwards is common, and your surgical team will discuss pain relief options with you. Ask your surgeon what to expect for your specific procedure.
2. How long does recovery take after kidney stone surgery?
Recovery time depends on which procedure you have, with some people returning to light activities within a few days and others needing a couple of weeks. Your surgeon will give you guidance tailored to your situation at your pre-admission clinic and follow-up appointments.
3. Will Medicare cover my kidney stone surgery?
Medicare generally provides a rebate towards the specialist and hospital costs of eligible procedures, and public hospital treatment can also be accessed via the elective surgery waitlist after referral. Your out-of-pocket costs depend on your circumstances, so ask your surgeon’s rooms for informed financial consent beforehand.
4. Can I avoid surgery if I have a kidney stone?
Many smaller kidney stones pass on their own with pain relief, fluids and time, so surgery isn’t always necessary. Your GP or urologist will usually monitor the stone with scans before recommending a surgical option if it isn’t passing or is causing complications.
5. What’s the difference between the main types of kidney stone surgery?
The three main approaches are shockwave lithotripsy (breaking up a stone with sound waves from outside the body), ureteroscopy (treating the stone via a thin scope) and percutaneous nephrolithotomy (removing larger stones through a small incision). Your urologist will recommend an option based on your stone’s size, position and type.