An Advanced Irrigation & Vacuum System
The advancement in kidney stone treatment provided by the SURE (Steerable Ureteroscopic Renal Evacuation) procedure’s irrigation and vacuum aspiration to clear kidney stone fragments offers urologists another effective tool in treating this common condition. Georgia Urology was the first practice in Atlanta and North Georgia to perform the SURE procedure.
While kidney stones and their often-debilitating symptoms can be effectively treated with various procedures, it’s important to understand that a goal of any kidney stone removal procedure is to get the patient stone-free. Being stone-free is ideal because any fragments remaining within the kidney may attract new urinary crystals. As Dr. Song mentions, Stones beget stones – remnant fragments increase the risk of stone recurrence. This means that, to the greatest reasonable extent possible, we aim to remove all pieces of kidney stone from the kidney or ureter, wherever they may be located. Traditional kidney stone removal procedures, such as ureteroscopy with laser lithotripsy, are the gold standard in treating kidney stones and removing most kidney stone fragments from the ureters. Other non-invasive technologies, such as external shockwave lithotripsy (ESWL), can effectively break up smaller and softer stones within the kidney; however, due to limitations in visualization and effectiveness, ESWL cannot ensure complete elimination of larger and harder stones.
Georgia Urology is proud to be one of the first practices nationwide and the first in Atlanta and North Georgia to work with and perform the SURE Procedure. One of the ways that SURE procedures can be done is with a special ureteroscope called a CVAC. This device is similar to a traditional ureteroscope, which allows the surgeon to visualize a stone while using a laser to break it apart.
The primary difference between SURE and external shockwave lithotripsy (ESWL) is the level of invasiveness. ESWL avoids instruments being placed into the body because it uses shock waves aimed directly at the kidney stone within the kidney. On the other hand, the SURE procedure is an advanced form of ureteroscopy, which involves passing a tube through the urethra and the bladder, and up the ureters to the kidney. While ESWL may be suitable for smaller, softer kidney stones, it is typically not effective for harder kidney stones or complex cases. In these cases, the SURE procedure may be more appropriate.
PCNL or percutaneous nephrolithotomy is a procedure that involves a small incision on the back. During the procedure, a tract is made more directly into the kidney. This is followed by the urologic surgeon using minimally invasive tools to visualize and destroy the kidney stone inside the kidney. PCNLs are significantly more invasive procedures than ESWL or ureteroscopy, so they are often reserved for the most complex of kidney stone cases. To that end, some SURE patients may benefit from the minimal invasiveness of the SURE procedure, which could be an option for certain large kidney stones that would otherwise require PCNL.
While we have three solid kidney stone treatment options with varying levels of invasiveness, adding the SURE procedure, which harnesses some of the benefits of each, is a good option in our armamentarium. For patients who qualify, the SURE system may be an option for getting them stone-free and reducing the likelihood of kidney stone recurrence in the future. With that said, the primary risk factor for developing kidney stones is lifestyle. Therefore, patients must be aware of what they are eating and drinking, ensuring they remain well-hydrated, especially during the summer months and when exercising vigorously.
Most importantly, rest assured that the urologists at Georgia Urology have the experience to identify and treat even the most complex of kidney stone concerns. We have a long track record of being the go-to practice in the southeast when relief is needed the most. We encourage patients to use our kidney stone hotline to get priority appointments to address their kidney stone concerns.