More than 500,000 people visit emergency departments each year for kidney stone problems. In the United States, one out of every eleven people suffers from kidney stones. These figures show a significant rise in stone disease.
Urine is rich in dissolved minerals and salts. Stones can form when your urine contains high levels of such minerals and salts. Kidney stones can start small but develop to fill the internal hollow structures of the kidney.
Most kidney stones do not cause discomfort unless they are attempting to pass from the kidney into the ureter. The kidney stone treatment that does not cause pain or other ailments can be analyzed and discussed depending on the size of the stone.
Let’s discuss how different kidney stone sizes require different medical attention.
1. Small Kidney Stones
Most small kidney stones (up to 5 mm in diameter) do not require treatment if they are not leading to symptoms. These stones may pass down the ureter on their own without the necessity for surgery.
Small stones can even pass through without causing the pain because they may not affect a blockage on their way out. Stones between 3 and 5 mm in size frequently cause slight pain as they pass down the ureter.
It usually keeps growing for months or years. Some stones maintain their size over time, but that’s less common.
Small kidney stones (less than 5mm) can be treated as follows:
- For the majority of the patients, observation is all that is required.
- Extracorporeal Shockwave Lithotripsy (ESWL)
- Ureteropyeloscopy
2. Medium Kidney Stones
Even if no symptoms are present, medium-sized kidney stones (5–20mm in diameter) should be treated. It’s because these estimations are unlikely to occur suddenly and are very likely to cause issues in the future. These stones can lead to pain, bleeding, urinary tract infections, and, in rare cases, kidney damage.
The following are the treatments available for kidney stones measuring 5–20mm:
- Extracorporeal Shockwave Lithotripsy (ESWL)
- Ureteropyeloscopy
- Percutaneous Nephrolithotomy is normally reserved for larger stones.
- If the patient is too weak for surgery, make an observation.
Extracorporeal Shockwave Lithotripsy (ESWL) and Ureteropyeloscopy are the two most popular treatments for these stones. The choice as to which of these two options is best is challenging and must be adapted to each clinical situation.
3. Large Kidney Stones
The size of large kidney stones is greater than 20mm. Large kidney stones almost always necessitate treatment, except if the patient is too frail or the procedure is too dangerous for the individual.
These stones have a high risk of causing ailments or long-term damage to the kidney’s function. Even large stones may not cause any pain, however, this does not mean they do not require medical attention. If remaining untreated, these stones can be highly dangerous and even fatal.
The following are the treatment options for large kidney stones:
- Percutaneous Nephrolithotomy (PCNL)
- Ureteropyeloscopy
- Open Renal Stone Surgery
- Laparoscopic Surgery
Extracorporeal Shockwave Lithotripsy (ESWL) is not commonly used for stones larger than 20mm because it is inadequate and affects multiple large fragments that cannot pass naturally.
Conclusion
Among many causes of kidney stones are diet, excess body weight, specific medical conditions, as well as certain supplements and medications. The kidney stone treatment depends more on its size. Additionally, the risk level also rises according to the size of the stones.
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