The patients who suffer from urinary system stones always have the following questions in mind:
- Do I require surgery for removal of stone and if yes then what kind of surgery?
- Will I get these stones again in life?
- Can I do something to prevent reformation of stones?
- Will they damage my kidneys?
Dr. Anupam Bhargava, Chairman, Urology, Max Smart Super Speciality Hospital, Saket answers all these questions.
Do I need surgery for removal of stone?
This depends on the location, size of the stone and the damage it is causing to our kidneys. A small stone sized 6 mm or less, which is in the urinary tube (Ureter) not causing much of swelling of the kidney, can be managed medically. You will not require surgery but you have to be under medical supervision.
Small kidney stones of size 5 mm also do not require surgery for removal, until and unless they come down and get stuck in the tube (Ureter).
Larger stones in the ureter causing swelling of the kidney or infection require immediate removal by ureteroscopy and Holmium LASER.
Small obstructing stones in the kidney also require removal by either Shockwaves (ESWL) i.e. crushing the stone from outside. This method is not so effective because the stones that are formed are hard calcium stones. The other method is by going to the kidney through ureter with the flexible scope and crushing the stones with Holmium LASER. This method is called Retrograde Intra Renal Surgery (RIRS). Large kidney stones can be removed by a small hole (approximately 5 mm) through the skin. This method is called Per Cutaneous Nephro Lithotripsy ( PCNL ). Now it is extremely rare to do open surgery for kidney stones.
Will I get kidney stones again?
There is a high probability that one gets the stone again in his lifetime.
Almost 40% patients can develop second stone in their lifetime. Therefore it is essential for stone formers to undergo regular follow up with the urologist whether they require surgical or medical therapy for stone treatment.
Can I do something to prevent reformation of stones?
To reduce the recurrence rate of stone formation patients require certain blood, urine tests, and stone analysis. Those patients who are identified with certain metabolic defects can be treated medically to reduce the reformation of stones. Otherwise, patients are advised to modify their diet and increase water intake.
Will they damage my kidneys?
Stones which block the kidney, whether they are in kidney or ureter and cause swelling of the kidney can gradually damage the kidney function. Stones can also cause recurrent infection in the urinary tract which can further damage the renal function. Therefore even asymptomatic stones should be kept under surveillance.