Kidney Stone Treatment

Renal stone disease is common in the Indian subcontinent due to the warm climate most times of the year, combined with the Indian dietary habits.

These stones most often form in the kidney and can then migrate down to the ureter or bladder

Majority of stones are calcium salts composed of Calcium Oxalate or Calcium Phosphate. 

Unlike Gallstones formed in the Gallbladder , which are treated only when there is pain, kidney stones need treatment, whether there is pain or not. It is not uncommon for a stone to grow to a very large size or the kidney to be totally destroyed , without any pain experienced by the patient. 

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Most cases of kidney stones can be treated by Endoscopic Surgery. The types of Stone Endoscopic Surgery are :

1. Per Cutaneous Nephro Lithotomy (PCNL) : Here a small needle puncture is made to the location of the stone. This is then used as an access path to put instruments into the kidney, break the stone and remove the pieces. It offers one of the most efficient forms of stone treatment irrespective of the stone size or location. There is however about 1-2 % risk of bleeding with this operation.
2. Ureterorenoscopy: (UR) :   A flexible or rigid instruments is passed up to the ureter or kidney from the urethra . On reaching the stone a laser or pneumatic instrument is used to break the stone and clear it. There is no cut externally on the body and recovery is rapid. 
3. Per Cutaneous Cystolithotrypsy.(PCCLT) :  This is an endoscopic procedure for bladder stones. Similar to PCNL , a small hole in the lower abdomen is made to the bladder stone, which is then fragmented and cleared
4. Extra Corporeal Shock Wave Lithotrypsy (ESWL) :  This is an entirely OPD procedure. Here shock waves from a  machine are focused on a kidney stone to fragement it. The small pieces of stones then pass out in the urine. This technique has the advantage of not needing admission and no anaesthesia needed. However the stone clearance has to occur naturally and hence may take 6-8 weeks. Sometimes more than one treatment sessions are needed.

After stone clearance, the stone is analysed. Appropriate diet and medicines are then prescribed to prevent stone recurrence