Kidney stones can cause intense pain and, if left untreated, may lead to permanent kidney damage, potentially resulting in renal insufficiency or even chronic kidney failure. Therefore, once kidney stones are diagnosed, treatment should begin immediately.
1. Increased Water Intake
This treatment is suitable for smaller kidney stones, typically those under 5mm, which do not significantly impact the body. Drinking more water and urinating frequently can help expel the stones through the ureter. It is recommended to consume at least 2000ml of water daily, which not only aids in eliminating kidney stones but also helps prevent them. If increasing water intake is ineffective, diuretics or medications to widen the ureter may be used under medical supervision to facilitate stone expulsion. However, for stones larger than 5mm, alternative methods are necessary to assist in stone removal.
2. Physical Activity
For smaller kidney stones, certain physical activities can be beneficial. The type of activity should be adjusted based on the stone’s location. For stones in the upper ureter or bladder area, jumping in place with both feet (landing on heels) for more than five minutes is recommended. For stones in the middle ureter, jumping on one foot at a time can be effective. If the stone is in the lower ureter, sideways jumping with one foot at a time can help promote expulsion.
3. Extracorporeal Shock Wave Lithotripsy (ESWL)
When kidney stones are small, they are often difficult to detect, so by the time most patients discover them, the stones have grown significantly, ranging from 5mm to 20mm. At this size, conservative treatments are insufficient, and ESWL may be considered. This procedure uses a machine to generate shock waves that are focused on the stone, breaking it into pieces that can then be expelled with the urine. Typically, ESWL does not require anesthesia, but it can cause minor trauma, such as bloody urine or ureteral obstruction.
4. Minimally Invasive Stone Removal
For patients who cannot undergo ESWL, minimally invasive procedures like ureteroscopy, percutaneous nephrolithotomy, and flexible ureteroscopy are available. Ureteroscopy involves inserting an endoscope through the urethra and bladder to the ureter and kidney to break the stones. This method is relatively simple and minimally invasive, offering good results but cannot reach the renal calyx.
Percutaneous nephrolithotomy is suitable for larger stones, generally those over 2cm. Although it is effective, it can cause kidney bleeding or damage to other organs, though these risks are relatively low.
Flexible ureteroscopy is similar to ureteroscopy but uses a flexible scope that can bend, allowing for multi-angle observation and access to the renal pelvis for stone removal. A stent is placed in the ureter before treatment to expand it.
5. Open Surgery
For large or uniquely shaped kidney stones that cannot be cleared using the above methods, open surgery may be considered. This involves cutting open the renal pelvis and kidney parenchyma to remove the stones. While this method can clear kidney stones completely, it is highly invasive and requires a long recovery time.