Kidney Stones : Treatment
Kidney stone treatment depends on the size and location of the stone(s), whether one or more stones are blocking the flow of urine out of the kidney, and whether there is evidence of infection. The phase of acute, intermittent pain usually lasts hours to 1 to 2 days. A stone, however, may take days or even weeks to pass. Sometimes weekly x-rays will be necessary to track the progress of the stone down the urinary tract. If the stone has not passed after a month or so, it may need to be surgically removed.
One may be treated at home by drinking lots of liquids and taking pain medication. Kidney stones usually pass on their own. The doctor will ask to strain all urine until the stone is passed. This allows the stone to be identified with lab tests.
If there is too much vomiting while drinking liquids, the patient may need to be hospitalized. A stay in the hospital may also be necessary if there are signs of urinary infection, a kidney abnormality, or a large stone requiring surgery.
ESWL: A stone located in the kidney that is less than 2 cms in size is usually treatable as an out-patient procedure using a special machine that produces high intensity sound waves called shock-waves called “Extra-corporeal Shockwave Lithotripsy”. The stones once broken pass out of urine as fine sand particles. Almost 90% of all kidney stones can be treated by this method.
Cystoscopy or ureteoscopy: If there is a stone in the lower urinary tract that requires surgery, it may be removed, under anesthesia, through a cystoscope. This instrument is a slim, lighted, flexible, fiberoptic telescope, which is passed through the urethral opening into the urinary tract. Tiny tools can be passed through the cystoscope and used to trap and remove the stone.
A stone that is too high or too large may require open abdominal surgery for removal. However, a new method for removal of higher or larger stones is through a type of operating telescope (a ureteroscope). The ureteroscope is inserted via the bladder.
Percutaneous Surgery or Open Surgery: This is reserved for large bulky stones in the kidneys. Less than 3 to 4 % of the patients require this form of major interventional surgery.