Author: Dr. John Maggioncalda
The treatment of kidney and ureteral stones is dependent on a number of factors. For most patients expulsive therapy will usually suffice. Expulsive therapy involves the use of analgesics, hydration and agents such as Tamsulosin to promote stone passage. If the pain from a stone can be controlled, most stones less than 6mm can be passed. For some patients with large stones or excessive pain or persistent nausea, expulsive therapy is not an option.
For larger stones, 6-7mm or greater, or for patients who fail expulsive therapy, extraction is usually preferred. Stone extraction requires ureteroscopic surgery. This procedure is often performed on an outpatient basis and requires about 45 minutes to complete. Pain post operatively is usually mild to moderate. Shock wave lithotripsy can also be performed as long as the stone is visible in the kidney or ureters. This technique is also performed on an outpatient basis with only heavy sedation. Post operative pain is usually mild.
Larger kidney stones (>1cm) are more difficult to treat and often require multiple procedures. For patients suffering from large stones a percutaneous lithotripsy is the procedure of choice. This technique requires general anesthesia and is accomplished by dilating a tract into the kidney through the back. A large sheath is passed into the kidney near the stone and specialized instruments are used to fragment and extract the stone pieces. Post operative pain can be significant, and a hospital stay of 1 to 2 days is customary.
If you have a kidney or ureteral stone it important to seek therapy right away. Contact a urologist to make a treatment plan that is customized to you and your stone. It is also important to follow up on a regular basis to monitor the success of the treatment and to form a plan to help prevent more stones from forming.
For larger stones, 6-7mm or greater, or for patients who fail expulsive therapy, extraction is usually preferred. Stone extraction requires ureteroscopic surgery. This procedure is often performed on an outpatient basis and requires about 45 minutes to complete. Pain post operatively is usually mild to moderate. Shock wave lithotripsy can also be performed as long as the stone is visible in the kidney or ureters. This technique is also performed on an outpatient basis with only heavy sedation. Post operative pain is usually mild.
Larger kidney stones (>1cm) are more difficult to treat and often require multiple procedures. For patients suffering from large stones a percutaneous lithotripsy is the procedure of choice. This technique requires general anesthesia and is accomplished by dilating a tract into the kidney through the back. A large sheath is passed into the kidney near the stone and specialized instruments are used to fragment and extract the stone pieces. Post operative pain can be significant, and a hospital stay of 1 to 2 days is customary.
If you have a kidney or ureteral stone it important to seek therapy right away. Contact a urologist to make a treatment plan that is customized to you and your stone. It is also important to follow up on a regular basis to monitor the success of the treatment and to form a plan to help prevent more stones from forming.
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