Kidney stones can be of some concern due to the extreme pain and inconvenience it poses to people’s lives. While hydration can help smaller stones to pass easily, those which are larger than 10mm would need medical aid to be removed. Such stones have the potential to block the flow of urine and lead to severe pain, infections, and immense damage to the kidneys if not treated on time.
If you or your family member has been diagnosed with larger sized kidney stones, the most common concern which comes to mind is what is the most effective way of getting it removed. This will largely depend on the overall symptoms, size, location, and the composition of the stone.
In this blog we will focus on the most recommended medical practices regarding the removal of kidney stones, why they are considered effective, and the time needed for recovery.
The Right Time For The Removal Of Large Kidney Stones
Kidney stones occur when the salts and minerals found in urine lock together and crystallize. Stones which are 5mm or less can be passed out naturally, however, it tends to get complicated above the 10mm mark.
You may need kidney stone removal if:
- There is a stone which is much larger than the average size which makes it difficult to pass.
- Pain which is intolerable and does not seem to fade away even with medication.
- Urinary Tract Infections along with fever.
- The calculi obstructs the normal flow of urine, leading to swelling of the kidney (hydronephrosis).
- It causes the presence of blood in the urine (hematuria).
- If you are having these problems, you should visit a urologist right away to avoid further complications.
Most Effective Methods to Treat & Remove Large Kidney Stones
Below are the Most Effective Methods to Treat & Remove Large Kidney Stones:-
1. Percutaneous Nephrolithotomy (PCNL) – Best for Staghorn Calculus or Larger Stones (Above 20mm)
PCNL is one of the most useful techniques for staghorn or above 2 cm stones removal.
How is PCNL Done?
A back incision of 1 cm is done to gain access to the kidney.
The stone is localized with nephroscope.
Ultrasound or laser is used to fragment the stone.
The small pieces are withdrawn through the cut; ultimately, scabbing of the incision is achieved.
Advantages of PCNL:
- Great efficacy regarding large complex stones: In addition to being the most advanced technique, PCNL stands at the forefront for significantly problematic cases being stones which other approaches may not make an attempt on.
- PCNL is takes less time than open surgery: Since conventional open techniques are much more complicated, patients need extended periods for healing and recovery, which is why these methods are preferred. Most of the patients are able to participate in normal activities after a few weeks.
- Reduced Chances of Recurrence: Because PCNL is capable of removing even the largest and the most intricate stones in a single session, the potential risk of recurrence is significantly decreased.
Recovery Period:
- Most patients spend between 48-72 hours in the hospital.
- The estimated recovery period post-surgery is approximately two to four weeks, depending on the specific case.
2. Retrograde Intra Renal Surgery (RIRS) – Most Effective For Mid To Large Stones Size (10-20mm)
This advanced method of RIRS removes kidney stones without making incisions or cuts using laser surgery. It is most appropriate for moderate-sized stones or when PCNL is not preferred.
How Is RIRS Performed?
A ureteroscope (a thin tube with a camera on top) is advanced through the urethra into the bladder and up to the kidney.
The laser knocks the stones into smaller pieces.
The fragments, like tiny dust, are excreted with urine.
Benefits of RIRS:
- No cuts or incisions: As a result of using the urinary tract, no other body parts are interfered with making it the least invasive method of stone removal.
- Less pain and speedier recovery: Wound-less procedures mean postoperative recovery will be a lot easier and more pleasant, enabling them to resume normal activities much sooner.
- Suitable for patients having bleeding tendencies: There is no external cut with this procedure hence, they are less susceptible to massive bleeding
- Patients with multiple renal calculi can be confident in this procedure: The laser treatment allows multiple stones to be fragmented in one sitting.
Recovery Time:
- A one day hospital stay in most situations.
- Most activities are back to normal in about a week.
3. Extracorporeal Shock Wave Lithotripsy (ESWL) – Most Effective For Stones With A Dimension Of Up To 15mm
The ESWL treatment involves the application of high energy shocks to break down larger kidney stones into smaller, more manageable pieces so that they may be easily passed through the urine.
How is ESWL Done?
The patient is then positioned on a treatment table, where a shock wave generator is aligned with the kidney.
The shock waves are aimed directly at the stone which then breaks the stone down to minute pieces.
These fragments are removed from the body over a period of several weeks through urine.
Advantages of ESWL:
- No cuts or surgical instruments are required hence the term non-invasive.
- It is classified as an outpatient procedure, so patients are free to go home the same day.
- Patients experience minimal discomfort compared to traditional surgical methods.
- The post-operative complications are fewer than standard surgery.
Recovery Time:
- Most patients will return to normal day to day activities after 1-2 days of rest.
- The entire process of passing all stone fragments can take several weeks.
4. Ureteroscopy (URS) – Most Useful For Ureteral Stones
The movement of stones from the kidney to the ureter (the tube from the kidney to the bladder) is well treated with URS.
Step By Step Procedure Of URS
With the aid of an ureteroscope (a rigid or flexible fiber optic scope), the stone is reached over the urethra and the bladder.
Shows A Laser Or Small Forceps To The Stone, Shatters Or Extracts It.
Occasionally, a stent is administered to maintain patency of the ureter, thus facilitating urine flow.
URT also have limitations as follows:
- Gantries do not permit the orthopedic surgeon to have direct sight of the stone as in minimally invasive pcnl. It is sighted in the position and rest frame.
- Shattering or crushing stones in one sitting is sufficient: Follow-up treatments are required in very few cases.
- Deficient In Achieving Effective Cleansing With Stones Found In The Bottom Portion Inside The Primal Urinary Bladder: The stones that are obstructing function of ureter are the most difficult to get.
Time Frame For Recovery
- Going back to their daily living is seen in most patients after two to three days.
What Is The Appropriate Treatment For You?
What is the most suitable treatment of stones in kidneys of large size is determined by: Finding the focus of the disease to be removed – stone location.
Moderate RIRS and ESWL are effective for average-sized stones, as PCNL is the most effective for the larger stones.
Medical history: RIRS is beneficial for patients who cannot undergo PCNL because of the high chances of bleeding.
Make sure to book an appointment with a good urologist for appropriate diagnosis and treatment of your condition.
Best Treatment for kidney stone by Dr. Deepanshu Gupta
Dr. Deepanshu Gupta has broad experience treating large and highly complicated kidney stones in a single sitting. His treatment is surgical, but requires very little intervention, allowing for a fast and easy recovery.
What Makes Dr. Deepanshu Gupta Unique?
- RIRS, PCNL, and ESWL technology practitioner for advanced kidney stone removal.
- Fluoroscopy-free RIRS – New and safer method of kidney stone surgery.
- More than 9500+ Endoscopic surgeries done in 12 years of practice.
- Urological precision of nephrolithiasis from any position within the kidney.
- Reduces recovery time and minimizes complications.
If you or someone you know is suffering from kidney stones, Dr. Deepanshu Gupta is the best surgeon to consult as he provides the highest level of care using the best technology available.
Final Thoughts
Self treatment of large kidney stones is never advisable, and planning the treatment properly will avoid complications and issues further down the line. An expert urologist will be able to prescribe the right course of action whether that isPCNL, RIRS, ESWL, or URS.
Make an appointment with Dr. Deepanshu Gupta for expert and fast relief from kidney stones.