Urologist and Andrologist
Kidney Stone Treatment
World Class Kidney Stone Treatment
When it comes to state of art kidney stone treatment, you get the best options and expertise with Dr. Raman. North India’s first Hyperphotonics laser makes scarless laser treatment safe and effective. In this page you will get a basic idea of what various surgeries are, when you need them and which one you should choose.
Can your stone be treated with just medicines ?
The first thing to understand is wether your stone can be managed with just medicines. Usually kidney stones less than 8 mm can be managed with medicines. Occasionally smaller stones that are stuck in the pipe of the kidney called the ureter also require removal but usually most ureteric stone less than 5mm can be managed with medicines.
Stones in the lower half of the pipe of the kidney are removed by a surgery called uretero-reno-scopy (URS) while stones in the kidney are managed with either lithotripsy (ESWL) or laser surgery such as RIRS or PCNL. Lets understand them in greater details.
ESWL
Lithotripsy uses sound waves to break stones without surgery. There is no needle, no scars and no need for anesthesia.Â
ESWL requires 2 to 3 sittings to break stones and stones pass out naturally through the kidney pipe called the ureter.
It is the easiest and safest procedure for kidney stones and also the least expensive
mini PCNL
Mini PCNL uses a 4 to 6mm hole to remove kidney stones in one sitting.
The effectiveness of this surgery to remove kidney stones is nearly 100%
PCNL procedure called percutaneous nephro-lithotripsy is the gold standard for stone management in the kidney
RIRS
Scarless kidney stone treatment using laser is possible through retrograde Intra-renal Surgery.
The procedure requires placement of a stent and also requires administration of anesthesia.
RIRS uses the latest technology and is the most modern surgery for kidney stones. Of course it comes at a cost.
Discuss your options with Dr. Raman
Every stone is different and the treatment needs to be customized based on patients preferences, urgency and severity of symptoms and economics. You can discuss your concerns with Dr. Raman Tanwar who has experience in successfully treating over 15000 patients with stone disease.
You can also read about each treatment individually in the sections down below. More details about each surgical modality are available on the links mentioned in the sections.
Ureterorenoscopy is a scarless surgery where the stones stuck in the lower part of the ureter are removed through natural urinary opening using an endoscope called the ureteroscope.
This surgery typically takes 15 to 30 minutes depending on the size of the stone
The surgery can be done in both regional as well as general anesthesia
Stent may be required after this procedure especially if there is a lot of infection or significant kidney swelling (Hydronephrosis)
ESWL or Extra Corporeal Shock Wave Lithotripsy is a painless and scarless way to manage kidney stones. In this procedure focussed sound waves are used to break the stones into small pieces which pass out through the ureters naturally.
This procedures requires 3 to 4 sittings of 40 minutes to an hour depending on size of the stone and its hardness
The stone clearance rate is 80 to 90 %.
There is no stay or anaesthesia required in this procedure.
The gold standard procedure for the treatment of kidney stones is PCNL. In this procedure a small hole is made in the back into the kidney and stone is broken down into pieces with laser and removed. Size of the hole is 4 to 6 mm in mini PCNL and 8 to 10 mm for standard PCNL.
This surgery takes 15 minutes to an hour depending on size of the stone and its hardness
The stone clearance is nearly 100%.
A DJ Stent is usually placed after the surgery to facilitate healing.
The RIRS is a scarless and ultramodern surgery to remove renal stones. In this surgery a flexible endoscope is passed from the urine passage into the kidney and the stones are broken with laser and removed.
The procedure happens in three phases. First a DJ stent is placed to widen the ureter. Two weeks later the RIRS is performed and subsequently the DJ stent is removed.
This surgery takes one to two hours depending on size of the stone and its hardness.
The stone clearance is 95% or higher.
A DJ Stent is usually placed after the surgery to facilitate healing.
Stones that are in the urinary bladder require simpler surgeries like cystolithotripsy (CLT) and percutaneous cystolithotripsy (PCCLT).Â
Sometimes laparoscopic surgery called Uretrolithotomy may be required for very large ureteric stones and Pyelolithotomy may be required for renal stones.
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