Kidney stones can be treated with medication, extracorporeal lithotripsy, endoscopic laser lithotripsy, or open surgery.
Kidney stones are a common urinary disease, occurring due to the deposition and crystallization of minerals in urine. MSc. Nguyen Truong Hoan, Department of Urology, Center of Urology – Nephrology – Andrology, Tam Anh General Hospital, Ho Chi Minh City, cited studies showing that about 1-13% of the world’s population has kidney stones. In Vietnam, about 2-12% of the population has urinary stones, 40% of which are kidney stones.
Depending on size, location, and complexity, kidney stones can be treated with the following methods:
Take medicines Can be prescribed for small kidney stones 4-6 mm. Using medicine in combination with drinking plenty of water is to increase urine output, dissolve and shrink the size of stones so they can be excreted through urine.
Extracorporeal shock wave lithotripsy (ESWL) is the gentlest method of treating kidney stones because it is less invasive, less painful, less complicated, and does not require anesthesia or anesthesia, according to Dr. Hoan.
The patient lies on a special machine system that can emit shock wave energy through the skin, breaking up kidney stones. Stone fragments are excreted through urine. This method is applied to kidney stones under 20 mm in size and soft in texture. After treatment, the patient can leave the hospital immediately.
Percutaneous endoscopic lithotripsy (PCNL) is a modern, minimally invasive method of treating kidney stones. The doctor inserts a small needle through the skin into the kidney under X-ray and ultrasound guidance. This “tunnel” then expands to about 0.5-1 cm, enough to insert the laser lithotripsy device inside. Under laser energy, the stones are crushed into fine pieces and then sucked out. This method can be applied to almost all types of kidney stones.
Endoscopic retrograde lithotripsy (URS), the doctor moves the endoscopic lithotripsy device upstream of the urinary system from the urethra to the bladder, passing through the ureters into the kidneys. Endoscopic retrograde lithotripsy can be performed using rigid and flexible tubes. Depending on the location, size of the stone, and the patient’s health status (whether there is a urinary tract infection, ureteral stenosis, impaired kidney function… or not), the doctor will prescribe the appropriate type of tube. Endoscopic retrograde lithotripsy is less invasive, has few complications, has a high stone clearance rate, patients recover quickly, and has a short hospital stay.
Doctor Truong Hoan performed retrograde endoscopic lithotripsy for the patient. Image: Tam Anh General Hospital
Open surgery Only applicable to some cases of stones with complicated infections, where endoscopic methods are limited. This method can be indicated to remove large stones with complex structures. The doctor makes an incision 12-15 cm long diagonally on the patient’s side to dissect and access the kidney. Next, the doctor opens the renal pelvis or kidney parenchyma to remove the stone and then stitches the incision after completion.
According to Dr. Hoan, open surgery is currently not a priority choice because it is highly invasive, leaves large scars, high risk of complications, heavy blood loss, and pain. After surgery, the patient recovers slowly, with many kidney functions damaged.
With kidney stones that are too large and have a complex structure such as coral stones, the doctor may need to combine many treatment methods and at least two treatments to completely clear the stone.
Even though the kidney stones have been removed, after treatment, patients need to change their living habits such as drinking lots of water (1.5-2 liters per day), limiting alcohol and carbonated drinks; reduce salt, animal protein, foods rich in oxalate (beets, chocolate, spinach…); regularly exercise and play sports. Patients need to have regular check-ups every 6-12 months to detect recurrent stones (if any) early when they are still small in size, and treat gently.
Doctor Truong Hoan said that people with symptoms of severe back pain, hematuria, recurrent urinary tract infections, painful urination, cloudy urine, fever, chills… are at risk of urinary tract diseases. The most common is kidney stones. At this time, the patient needs to go to the hospital for timely examination and treatment to avoid dangerous complications such as kidney infection, hydronephrosis, and impaired kidney function.