Kidney Stone Treatment in Bhubaneswar

Diagnosis of Kidney Stones

The urologist will check your medical history report and examine the ongoing symptoms. It is important to determine the exact location, size, and number of stones to proceed with the course of the procedure. The doctor may recommend several diagnostic tests to confirm the presence of stones. Some of the diagnostic tests for kidney stones are-

• Blood tests – Examine contents of calcium, phosphorus, uric acid, and electrolytes.
• Blood urea nitrogen (BUN) and creatinine – Indicates any abnormal functioning of the kidneys.
• Urinalysis – Includes assessment of urine contents and indicates any bacteria, blood, etc.
• Imaging tests – Include abdominal X-rays, ultrasound, MRI, and CT scan.

4 Methods of Kidney Stones Removal

Kidney stones vary in size and shape. Some stones that develop in kidneys can form staghorn calculus which requires immediate surgical removal. Generally, kidney stones of size 4mm or less do not require surgical procedure. The doctor recommends drinking excess water and prescribes medications to reduce pain and expel stones through urination. However, if the size of the stone is large and causes major pain, surgery is inevitable. There are four types of procedures to treat kidney stones-

RIRS (Retrograde Intrarenal Surgery)

• The surgeons prefer RIRS to treat kidney stones of sizes 8mm to 15mm due to the advanced tools involved in the treatment.
• The patient is administered with either spinal or general anesthesia.
• The doctor may choose to insert thin stents into the ureter through the urethra to expand the passage of the ureter. This helps in reducing pain and allows the smooth movement of stones during expulsion.
• A thin, flexible instrument called an endoscope is inserted in the urethral opening. The surgeon determines the location of stones via x-rays and an external monitor guides the surgeon during the procedure.
• The stones are broken into smaller pieces and expelled from the body through urine.

ESWL (Extracorporeal Shock Wave Lithotripsy)

• ESWL is a non-invasive treatment that involves external shockwaves to break the stones into smaller pieces.
• It is generally recommended for kidney stones of sizes between 5mm to 8mm.
• The patient is administered with spinal anesthesia to reduce the pain during the procedure.
• ESWL may require more than one sitting to completely break the stones.

URSL (Ureteroscopic Lithotripsy)

• The patient is administered with spinal or general anesthesia.
• The surgeon uses a thin instrument called a ureteroscope that is attached with a camera and laser on the other end.
• The camera guides the surgeon by providing live images throughout the surgery.
• The stones are broken into smaller fragments via lasers and the pieces are flushed out through urine.
• Stents may be used to expand the ureteral opening and reduce pain while flushing out stones pieces through urine.
• The stents are kept inside the body until the stones are fully flushed out of the body. They can be removed immediately after the procedure or during a consecutive visit to the doctor.

PCNL (Percutaneous Nephrolithotomy)

• Percutaneous nephrolithotomy is a minimally invasive (sometimes referred to as laparoscopic surgery for kidney stones) procedure to remove renal stones greater than 14mm in size.
• The patient is administered with general anesthesia.
• A small keyhole incision (around 1cm) is made in the flank (lower back) area.
• The urologist uses a long, thin nephroscope attached to a tiny laser on the other end.
• Once the stones are located, the doctor bombards tiny lasers on the stone to break them into smaller fragments.
• These fragments are then removed and the wound is shut using surgical sutures.