Things to Know What Size of Kidney Stone Requires Surgery?

Even though many reasons can lead to kidney stone formation, it is ideal to treat them on time to avoid problems. Depending on the kind of stone a person has, the line of treatment is recommended.

Before one proceeds with the treatment, it is essential for them to consult their healthcare providers and have a thorough analysis of the kidney stone size. It is only after knowing the size that the doctor decides the treatment. While sometimes one may need kidney stone laser treatment, sometimes medications are enough.

What are Kidney Stones?

When you have an excessive amount of minerals in your urine, kidney stones can form as solid bits of material. Calcium accumulation is typically the cause of them. These stones often originate from the kidney and can pass through the rest of the urinary system, even though their size and composition may differ.

Variations and Sizes of Kidney Stones

Different types of kidney stones can be found in the body. These have been known to differ based on their composition and the patient’s age and sex. Here are the common variations and sizes of kidney stones:

1. Calcium Oxalate Stones: The most common form of kidney stone, calcium oxalate stones account for over 80% of occurrences. These stones develop when calcium and oxalate mix in the urine. Calcium oxalate stones range in size from small grains to massive stones several centimetres in diameter.
2. Calcium Phosphate Stones: Although less common than calcium oxalate stones, calcium phosphate stones account for a significant share of kidney stones. When calcium and phosphate mix in the urine, they create stones. Depending on how long the stones have been in the kidneys, they can be small or huge.
3. Uric Acid Stones: It occurs when excess uric acid is present in the urine. These stones are typically smaller, ranging from a few millimetres to a centimetre. They can be challenging to detect on regular X-rays and may necessitate specialised imaging tools.
4. Struvite stones: Struvite stones are less prevalent and are usually caused by urinary tract infections (UTIs). They can develop quickly, sometimes occupying the entire kidney or both kidneys.
5. Cystine Stones: Cystine stones are uncommon and are caused by a hereditary disease. It can impair the capacity of kidneys to reabsorb cystine, an amino acid. These stones can range in size and frequency if not adequately managed.

Factors Affecting the Treatmen

Many effective treatments are available for kidney stones. However, certain factors cause fluctuation in the success rate of the treatment. Here are the key factors affecting the treatment of kidney stones:

1. Stone sie: The size of the kidney stone is an important aspect in selecting the removal technique. Smaller stones, such as grains or crystals, frequently pass through the urinary tract unnoticed. Medium to large stones, on the other hand, may need surgical removal.
2. Stone Composition: Each type of stone (e.g., calcium oxalate, uric acid, struvite, etc.) requires a different treatment approach, as their response to various therapies can vary. Understanding the stone composition is essential for choosing the most effective treatment option.
3. Symptoms and Complications: The severity of kidney stone symptoms, such as pain, blood in the urine, or urinary tract obstruction, impacts the urgency and type of therapy required.
4. Patient’s Overall Health: The patient’s age, overall health, and medical history all play a part in identifying the best treatment. Specific medical issues may limit treatment options or necessitate changes to the chosen method.
5. Stone Formation Frequency: Patients with a history of recurring kidney stones may require further investigation to discover underlying reasons and apply preventive measures.

What is the Treatment for Kidney Stones?

Conservative treatments, medicinal therapies, and occasionally surgical procedures treat kidney stones. The course of treatment is determined by several variables, including the size, location, makeup, severity of the kidney stones, and the patient’s general health.

Factors to Consider for Treatment According to Sizes

Before treating kidney stones, one needs to know what kind of stones they have. It is done with the assistance of a healthcare provider. Here are the factors to be considered for treatment based on different stone sizes:

1. Small stones (size less than 5 mm in diameter)

• Extracorporeal Shock Wave Lithotripsy (ESWL): Small stones are frequently treated with extracorporeal shock wave lithotripsy (ESWL). It is a non-invasive treatment that employs shock waves to break the stones into smaller bits. The fractured stones are removed via the urinary tract.
• Ureteroscopy (URS): It may be preferred for tiny stones found in the ureter or adjacent to the bladder. A thin, flexible scope is used to pass through the urinary tract to detect. It breaks them into smaller pieces to pass through urine.

2. Stones of medium size (5 mm to 1.5 cm)

• Percutaneous Nephrolithotomy (PCNL): A minimally invasive surgical treatment for medium-sized kidney stones. A small incision in the back is made to access the kidney and immediately remove the stones.
• Retrograde Intrarenal Surgery (RIRS) is a minimally invasive procedure for treating kidney stones located within the kidney or upper part of the ureter. It involves accessing the stone through the urinary tract using a small, flexible ureteroscope. It is passed through the urethra and bladder into the affected kidney. The ureteroscope allows the urologist to directly visualise the stone and use laser energy to break it into smaller fragments. It is then removed or naturally passed out of the body.
• Flexible Ureteroscopy with Laser Lithotripsy: It may be utilised for medium-sized stones in the ureter or closer to the bladder. Using laser energy, the surgeon may reach the stone and break it up into smaller bits.

3. Large or complex stones (greater than 1.5 cm)

• PCNL stands for Percutaneous Nephrolithotomy: For large kidney stones or complex stones that are difficult to cure with other procedures. PCNL is the chosen surgical treatment. It provides direct access to the kidney for successful stone removal.
• Nephrolithotomy (Open Surgery): Open surgery, known as nephrolithotomy, may be considered in rare circumstances if PCNL or other minimally invasive procedures are not viable. A larger incision in the back is made to remove the big stones.

Preventive Measures:

1. Hydration: Drinking more water helps wash out the urinary system. It allows the passing of smaller stones and prevents the creation of new ones.
2. Pain management: Nonsteroidal anti-inflammatory drugs (NSAIDs), available over the counter, can be used to treat the pain and discomfort brought on by kidney stones.
3. Medication: Specific medications may be recommended to aid in the dissolution or prevention of stones. It depends on the nature of the stones. Alpha-blockers, for instance, can relax the muscles in the urinary tract, making it easier for stones to pass through.

Conclusion

Larger kidney stones needing surgical intervention can be managed with a highly effective and least invasive laser treatment method. Many patients prefer it because of the accurate stone fragmentation and low risk of consequences.

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