Kidney stones, also known as nephrolithiasis, are hard deposits of minerals and salts that form inside the kidneys. They can cause severe pain and discomfort, and their treatment varies based on size, location, and composition. This article explores the different treatment modalities available for kidney stones, emphasising both noninvasive and surgical options.

Symptoms of Kidney Stones

• Severe Pain: Sudden onset of intense pain in the abdomen, side, or back that may radiate to the groin or testicles.
• Changes in Urine: Abnormal urine color, presence of blood (hematuria), or foul-smelling urine.
• Systemic Symptoms: Chills, fever, nausea, and vomiting may also occur.

Non-Invasive Treatment Options

Extracorporeal Shock Wave Lithotripsy (ESWL):

This is a widely used non-invasive procedure where shock waves are directed at kidney stones from outside the body to fragment them into smaller pieces.

Indications: Best suited for stones less than 2 cm in size.

Advantages: No need for anaesthesia or incisions; minimal recovery time.

Disadvantages: Potential for incomplete stone clearance; may require multiple sessions.

Ureteroscopy (URS):

A thin tube (ureteroscope) is inserted through the urethra and bladder into the ureter to locate and remove or break up stones using laser technology.

Advantages: Effective for stones located in the ureter; minimal recovery time.

Disadvantages: May require general anaesthesia; risk of complications such as infection or bleeding.

Percutaneous Nephrolithotomy (PCNL):

A minimally invasive procedure where a small incision is made in the back to remove large kidney stones using a nephroscope.

Indications: Recommended for larger stones (2 cm) or staghorn calculi.

Success Rate: High clearance rates (95%) when performed by experienced surgeons34.

Risks: Includes potential bleeding and infection, though these are relatively low compared to open surgery.

Open Surgery:

Rarely performed today due to advancements in minimally invasive techniques; indicated for very large stones or when other methods fail.

Indications: Severe cases where stones are obstructing urine flow or causing significant complications.

Conclusion

The choice of treatment modality for kidney stones depends on various factors including stone size, location, patient health, and preferences. Non-invasive options like ESWL and URS are effective for many patients, while surgical interventions like PCNL remain crucial for larger or more complex stone cases. Consulting with a qualified urologist, such as Dr. Abhijit Gokhale in Pune, can help determine the most appropriate treatment plan tailored to individual needs.

Dr. Abhijit Gokhale has over 25 years of experience in urology and offers comprehensive kidney treatment in Pune options at Sanjeevan Surgery in Shivajinagar, Pune. His expertise ensures that patients receive high-quality care tailored to their specific conditions.