I see many patients send their ultrasound report showing size of stone and ask what to do. This article can be very useful for them.
1. Very small size stones (3-5 mm): This size of stone requires conservative management like high fluid intake, less salt intake, less meat intake and correct abnormalities based on a metabolic evaluation of stones. Chances of spontaneous passage of this size of the stone are very high. Special precaution should be taken in case of high-risk job profile like pilots in whom stone can drop down into the ureter and cause severe colicky pain while flying, those people are advised stone removal prophylactically by RIRS (Retrograde Intrarenal Surgery)
2. Stone size (6-10 mm): This size of stones can be tackled by either ESWL (Extracorporeal Shock Wave lithotripsy) or RIRS (Retrograde intrarenal surgery)
3. Stone size (more than 10 mm): This size of stones is tackled by PCNL (Percutaneous Nephrolithotripsy)
- ESWL: Shock waves are focused on the stone and the stone breaks into small pieces and removes out of kidney spontaneously.
- RIRS: Through urethra flexible nephroscope is passed and with the help of the laser energy the stone is broken into fragments and is removed.
- PCNL: Small opening into the kidney is made with the help of a needle and this opening is dilated and then through dilated tract nephroscope is passed and the stone is fragmented into small pieces and removed.