Kidney and ureteric stones: treatment in Krasnoyarsk

A kidney or ureteral stone: how treatment is chosen

Management depends on the stone's location, size and presumed composition, kidney status, pain and signs of infection. A stone found incidentally on ultrasound and one blocking the ureter require different decisions. During the consultation, we review the images and determine whether observation is possible or intervention is needed.

Observation is acceptable in selected situations without complications and with an agreed monitoring plan. For some ureteric stones, a doctor may prescribe treatment to help them pass. Uric acid stones can sometimes be dissolved by changing urine acidity under medical supervision; this approach does not suit every stone. Self-treatment based on a single line in an ultrasound report is unreliable.

How removal methods differ

Each method has limitations, risks and a chance of requiring another procedure. Sometimes urinary drainage must be restored first and the stone removed later. The specific method and place of treatment are determined after assessment.

• PCNL removes a stone through a small access in the lower back area. It is often considered for large and complex kidney stones.
• RIRS uses a flexible instrument inside the kidney, inserted through the natural urinary tract, usually with laser fragmentation.
• Ureteroscopy is endoscopic removal or fragmentation of a ureteral stone through the urethra and bladder.
• ESWL breaks up stones using shock waves from outside the body. It is not suitable for everyone: the result depends on stone characteristics and anatomy.

When urgent help is needed

Flank pain with fever or chills, no urine output, pain that cannot be controlled and repeated vomiting are reasons to seek urgent care. Delays are especially dangerous with a single functioning kidney. If a stone blocks drainage and an infection develops, emergency drainage may be required. A questionnaire and messages cannot replace hospital care.

What to prepare for your consultation

Bring the report and actual CT images if CT has already been performed, ultrasound results, urinalysis, culture and creatinine results. Also bring discharge summaries from previous operations and a medication list, including drugs that affect blood clotting. Do not stop them yourself.

Explain when the pain began, whether there was fever, whether you have passed stones before and whether a stent remains in place. You do not need to complete the entire set of tests in advance: additional investigations depend on the situation.

After removal: reducing the risk of new stones

Removal gets rid of a particular stone, but not always the cause of its formation. A saved fragment can be analysed for composition. Further tests are chosen according to stone type and recurrence risk; not everyone needs a comprehensive 24-hour urine analysis.

We discuss adequate fluid intake in light of other illnesses, salt, diet and weight control. Dietary calcium should not be completely excluded without an indication. Ideally, obtain a follow-up and prevention plan together with the treatment outcome.