What is Laser Therapy for Kidney Stones

Laser therapy for kidney stones is a procedure to break up small, hard mineral deposits that form in the kidney (kidney stones). The procedure is done using a device that produces a focused beam of light (laser).

The laser breaks up kidney stones into pieces that are small enough to be passed out of the body through urination or removed from the body. You may need laser therapy if you have kidney stones that are painful or block your urinary tract.

This procedure is done by inserting a tube (ureteroscope) into your kidney through the urethral opening. The urethra is the tube that caries urine out of the body. In women, the urethra opens above the vaginal opening. In men, the urethra opens at the tip of the penis. The ureteroscope is inserted through the urethra, and surgical instruments are moved through the bladder and the tube that connects the kidney to the bladder (ureter) until they reach the kidney.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to the urethra, bladder, or ureter.
• Urinary tract infection (UTI).
• Narrowing of the urethra (urethral stricture).
• Difficulty passing urine.
• Blockage of the kidney caused by a fragment of kidney stone.

What happens before the procedure?

• Follow instructions from your health care provider about eating or drinking restrictions.
• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• You may have a physical exam before the procedure. The exam may include imaging studies and blood or urine tests.
• You may be given antibiotic medicine to treat or prevent infection.
• If your ureter is too narrow, your health care provider may place a soft, flexible tube (stent) inside of it. The stent may be placed days or weeks before your laser therapy procedure.
• Ask your health care provider how your surgical site will be marked or identified.
• Plan to have someone take you home after the procedure.
• If you will be going home right after the procedure, plan to have someone stay with you for 24 hours.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
• A ureteroscope will be inserted into your urethra. The ureteroscope will send images to a video screen in the operating room to guide your surgeon to the area of your kidney that will be treated.
• A tube will be threaded through your bladder and ureter, up to your kidney.
• The laser device will be inserted into your kidney through the tube. Your surgeon will pulse the laser on and off to break up kidney stones.
• A surgical instrument that has a tiny wire basket may be inserted into your kidney to remove the pieces of broken kidney stone.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
• You will be given pain medicine as needed.
• You may continue to receive antibiotics.
• You may have a stent temporarily placed in your ureter.
• You may be asked to strain your urine to collect any stone fragments that you pass. These fragments may be tested.
• Do not drive for 24 hours if you received a sedative.

Laser Therapy for Kidney Stones, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information on caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• Pain.
• A burning sensation while urinating.
• Small amounts of blood in your urine.
• A need to urinate frequently.
• Pieces of kidney stone in your urine.
• Mild discomfort when urinating that is felt in the tip of the penis in men or in the back. You may experience this if you have a flexible tube (stent) in your ureter.

Follow these instructions at home:

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Take your antibiotic medicine as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.
• Drink enough fluid to keep your urine clear or pale yellow. Your health care provider may recommend drinking two 8-ounce glasses of water per hour for a few hours after your procedure.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• If your health care provider approves, you may take a warm bath to ease discomfort and burning.
• Do not drive for 24 hours if you were given a medicine to help you relax (sedative).
• Keep all follow-up visits as told by your health care provider. This is important. If you have a stent, you will need to return to your health care provider to have the stent removed.

Contact a health care provider if:

• You have pain or a burning feeling that lasts more than two days.
• You feel nauseous.
• You vomit more and more often.
• You have difficulty urinating.
• You have pain that gets worse or does not get better with medicine.

Get help right away if:

• You are unable to urinate, even if your bladder feels full.
• You have bright red blood or blood clots in your urine.
• You have more blood in your urine.
• You have severe pain or discomfort.
• You have a fever or shaking chills.
• You have abdominal pain.