SWL is usually used to treat stones that are located in the upper part of the kidney or the uretersand that are smaller than 2.5cm. No incision is necessary, but the patient is asleep for the procedure. After SWL small fragments of pulverized stone can usually pass with minimal discomfort. Percutaneous kidney stone removal is performed by making a one-inch incision on the patient's side, which allows the surgeon to enter the kidney and remove the stone piece by piece. This procedure is recommended for stones that are located in the lower half of the kidney, or that are larger than 2.5cm.
Percutaneous surgery is the surest way to remove all of the stone.
Ureteroscopy with laser lithotripsy is used for stones located in the ureter. The ureteroscope is inserted in the urethra, passed through the bladde, and into the ureter. The stones are visualized, then fragmented with laser energy, and removed through the urethra. No incisions are made, although the patient is asleep for the procedure. Stones in the bladder can be fragmented and removed without an incision, except in cases where the stones are exceptionally large.