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Kidney Stones

What are the Symptoms of Kidney Stones?

A kidney stone may not cause symptoms at all, and can go undiagnosed. However, if a stone blocks the flow of urine out of the kidney, it can cause significant pain. If that occurs, you may experience these additional symptoms:

  • Severe cramping pain in the side and back, below the ribs, often moving to the lower abdomen or groin
  • An intense and persistent need to urinate
  • Urinating more often than usual
  • Burning or pain when urinating
  • Urine that is dark or red due to blood
  • Nausea and vomiting
  • Men may feel pain at the tip of the penis

How Are Kidney Stones Treated?

Most kidney stones pass out of the body without treatment.  You may be able to pass a small stone by increasing the amount of water you drink, taking pain relievers or by using medications prescribed by your doctor.

PCNL Kidney Stone Treatment

Percutaneous nephrolithotomy (PCNL), and particularly tubeless PCNL, has become the standard treatment for removing large kidney stones, and requires general anesthesia. In fact, Dr. Abbott is a pioneer of the tubeless PCNL procedure and has successfully performed many of these intricate surgeries as a same-day procedure in an outpatient facility.

Tubeless PCNL

The tubeless PCNL procedure is performed as PCNL surgery, and involves surgically removing a kidney stone using a small rigid telescope (nephroscope) and instruments inserted through a small incision in your back or side. The instrument passed through the nephroscope breaks up the stone and suctions out the pieces (making it the best treatment choice for large stones).

What makes the procedure unique is that a nephrostomy (drainage) tube is not required. In traditional PCNL procedures, a drainage tube exits the surgical site through the patient’s skin and is used to drain excess fluid from the kidney such as urine and blood post-operatively, or provide access if re-entry into the kidney is necessary.

There are several advantages of the Tubeless PCNL approach:

  • Minimized post-operative pain
  • No leakage of urine and blood from the nephrostomy tube
  • Quicker recovery
  • Shorter length of hospital stay

Ambulatory Tubeless PCNL

An Ambulatory PCNL is a modified tubeless PCNL that allows patients to go home the same day of the procedure. Dr. Abbott is the only surgeon in the Western United States who performs a tubeless PCNL in a freestanding surgery center.

Not all patients are candidates for an ambulatory tubeless PCNL.  Dr. Abbott will discuss your particular case, medical history and current health with you and determine if this is an option.

An ambulatory tubeless PCNL procedure is performed in Avalon Surgery Center’s state-of-the-art ambulatory surgical center specially equipped with the advanced instruments and technology required to perform this complex surgery. Avalon Surgery Center is also staffed with nurses experienced and specially trained in the PCNL procedure, ensuring the highest level of patient care.

Other Types of Kidney Surgery

Surgery may be needed to remove a stone from the ureter or kidney if:

  • The stone fails to pass
  • The pain is too great to wait for the stone to pass
  • The stone is affecting kidney function


Surgical procedures for kidney stones include:

Shock wave lithotripsy (SWL)

SWL is used to treat stones in the kidney and ureter by focusing shock waves on the stone using x-rays or ultrasound that break the stones into tiny pieces. These smaller pieces of pass out in the urine over the course of a few weeks. The procedure typically lasts about 45 to 60 minutes and can cause moderate pain, which may require sedation or light anesthesia to make you comfortable.

Ureteroscopy (URS)

URS is used to remove smaller stones in the kidney or ureter. The procedure involves passing a tiny telescope, called a ureteroscope, through your urethra and bladder to your ureter, and into your kidney.

Once the stone is located, special tools can snare the stone or break it into pieces that will pass in your urine. Your doctor may then place a small tube (stent) in the ureter to relieve swelling and promote healing. General or local anesthesia may be required during this procedure.

Other Surgical Procedures

In rare circumstances, open, laparoscopic or robotic surgery may be used if all other less invasive treatments fail.

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