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When you have been found to have a narrowing inside the kidney, three minimally invasive treatment options are available for you at the Urology Academic Practice. A narrowing inside the kidney leads to incomplete emptying of a portion of the kidney (called diverticulum) with dull back pain and possible stone and infection complications.
Retrograde Intrarenal Surgery (RIRS)
In most patients, this condition can be repaired by RIRS. A small telescope goes through the natural opening of the body, into the ureter and up into the kidney. The narrow part is cut with a laser. If there is a stone, it is taken out at the same time. A small tube (stent) is left in the ureter for about two weeks to allow proper healing. RIRS is an outpatient procedure. The stent is removed at a follow-up office visit.
Percutaneous Kidney Surgery
Percutaneous kidney surgery is the treatment of choice for patients with larger stones and when the stricture is in the lower part of the kidney or when RIRS cannot be done. This minimally invasive endoscopic surgery allows the surgeon to perform surgery within the kidney using a small tract. A tract is an opening created by a small incision through the skin and tissues directly into the kidney. A sleeve bridges the distance from the skin into the kidney. Surgery is performed by guiding endoscopic instruments through the sleeve into the kidney.
Laparoscopy is performed for those patients with very large stones in their diverticulum. In this procedure, three little incisions are made into the abdomen so that small surgical instruments can go into the abdomen and the kidney. The diverticulum is cut open, and the stones are taken out. A stent is emplaced either before this treatment or in the operating room. The stent is left in the ureter for six weeks to allow it to heal properly. The procedure requires an overnight stay in the hospital. The stent is removed at a follow-up office visit.
The Urology Academic Practice specializes in treating patients who have had failed previous treatment attempts, patients with very large stones, patients with strictures and patients with tumors. Children and patients with bleeding disorders or gross obesity are also treated at the Program.