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Kidney Stone Treatment Methods

When people apply to the emergency department with severe pain when stones smaller than 10 mm formed in their kidneys fall into the urinary canal, sometimes when they apply to a doctor with ambiguous pain, it can be detected that they have kidney stones. In this case, the doctor he goes to directs the patient to the urology specialist. The urologist also offers the patient various treatment options. In fact, since these options may vary according to each doctor, the confused patient is confused about what to do.

While the doctor offers a treatment option, he makes recommendations based on his knowledge, experience and dexterity. I also wanted to share my views on this matter.

Stones smaller than 10 mm

When stones smaller than 10 mm fall into the urinary canal, they cause severe pain and progress to the lower end of the ureter (the entrance to the urinary bladder). Since the average diameter of this part is 2 mm, 2-3 mm stones fall with mild pain, while 4-5 mm stones usually fall with severe pain that can last for a few days. Stones larger than 5 mm get stuck here. It causes both severe pain and enlargement of the kidney channels. This means that kidney functions are adversely affected. These stones should be treated with endoscopic method (ureterorenoscopy). The stone is reached by entering through the urinary tract with a thin fiberoptic device, and it is broken out and removed. Since it is an easy and harmless method, patients should not hesitate to make a decision.

stones between 10-20 mm

If the stone size is 10-20 mm, the stone breaking method with sound waves from outside the body (ESWL) is tried for these patients since there is no possibility of stone falling out. In addition, ESWL is an easy option for easy removal for stones larger than 5 mm that fall into the urinary canal. Thus, large stones can be broken into small pieces with this method, allowing them to fall more easily. The success rate is 80%.

Stones larger than 20 mm

If the stone cannot be broken or is larger than 20 mm, it is necessary to plan surgery. Previously, the only option was to enter the kidney with a 20-25 cm incision in the kidney region with the classical method and reach the kidney and remove the stones from the collecting system of the kidney. The cut areas were stitched with suitable threads and the process was terminated. After this surgery, the patient's recovery was long and the complication rate was higher.

Percutaneous nephrolithotripsy (PNL) is the surgical method that has been widely applied in recent years, following the advancement of technology and science. Surgery performed with this method is more advantageous than classical surgery in terms of faster recovery and complication rate. In PNL surgery, a 10 mm diameter cannula is inserted from the posterior region into the renal collecting system. The stone is removed by breaking with the camera.

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