Which therapy for which stone? | Therapy of kidney stones

Which therapy for which stone?

Renal calyx stone is usually not in need of therapy if there are no complaints, urinary retention or infection. In case of blood in the urine and non-treatable infection, as well as in certain occupational groups (pilots, professional drivers) ESWL renal pelvic stoneIn case of a stone (>5 mm) ESWL or PNL that cannot be removed spontaneously Spout stoneIn most cases there are no symptoms, but chronic inflammation of the renal pelvis (pyelonephritis) with subsequent renal failure and death can occur. Therefore, surgery should be performed: ESWL, PNL or a combination of both.

Afterwards, a so-called stone road can develop through outgoing debris, which must be surgically removed. High ureteral stoneIf there is a clear urinary stasis, a spontaneous discharge can be excluded. ESWL or endoscopic removal (mechanical removal) are favorable.

Deep ureteral calculusUp to a size of 5 mm, it can disappear spontaneously. If kidney function remains normal, non-surgical measures can be used. Bladder stoneThe stone should be crushed and then aspirated with the suction pump. Afterwards the underlying disease (e.g. prostate enlargement) should be addressed.

Duration of the treatment

Depending on the type of therapy, the duration of treatment varies. If the kidney stones are removed by conservative therapy, i.e. without surgery, the time span cannot be specified exactly. It is more likely to be months of therapy (change of diet, use of household remedies, homeopathic remedies or medicines).

After non-contact stone fragmentation using extracorporeal shock wave lithotripsy (ESWL), the inpatient stay is only 1-2 days. If the stone is larger than 5mm, surgery is indicated. If percutaneous nephrolitholapaxy (PCNL) has taken place, i.e. direct removal of the kidney stones by puncture through the skin with the help of an endoscope, an inpatient stay of 4-5 days is to be expected and physical rest of about 2 weeks after the hospital stay.

After a ureterrenoscopy, a ureteroscopy and removal of the stones with forceps, the inpatient stay lasts 2-4 days. The duration of a hospital stay after insertion of a ureteral splint to keep the ureter open is about 2 days and the splint usually remains in place for only 1 week. However, it may only remain in place for a maximum of 3 months.