Mr Ben Grey
There are a number of treatment options available. A good surgeon will consider not only the stone that requires urgent treatment, but also whether there are any other stones within the urinary tract that could be treated simultaneously to avoid future symptoms. Of course, the overall health of the patient and their suitability for the treatment options is an extremely important consideration. Equally, private patients benefit from a shorter treatment pathway and an earlier return to work.
Treatment options include:
Conservative treatment - Depending on the size and position of stones, the specialist may suggest just monitoring the patient. This may work for those patients who have small stones in the ureter that have a high likelihood of passing through, or stones in the kidney that cause no symptoms. Equally, conservative treatment may be preferred for those patients with associated high risk medical conditions.
Medical treatment - Certain types of stones (e.g. Uric Acid) can be dissolved after accurate diagnosis of the stone type. It can be difficult to elicit the type of stone unless there is an associated medical condition or piece of stone available for formal analysis.
Extracorporeal Shock Wave Lithotripsy (ESWL) - This treatment is non-invasive and doesn't require an anaesthetic. X-rays or ultrasound are used to find the stone and then shock waves are focused from outside the body on to the stone, cracking it into smaller pieces which then pass out of the body in the patient's urine.
Ureteroscopy - This minimally-invasive treatment is performed under general anaesthetic and involves a small camera (ureteroscope) being passed through the bladder to the ureter and/or kidney, depending on where the stone is situated. Commonly, a laser is then used to fragment the stone into small pieces which then either pass out the body in the urine, or can be helped out with small basket retrieval devices.
PerCutaneous NephroLithotomy (PCNL) – This is another minimally invasive technique performed under general anaesthetic, accessing the kidney and/ or the ureter via a small skin incision in the back. A larger camera (nephroscope) and ultrasonic/hydraulic fragmentation device or a laser is used to treat larger kidney stones and stones in the ureter which can't be accessed by a ureteroscope.
A specialist in stone treatment should be able to discuss the benefits and risks associated with each of the treatments, so a bespoke treatment plan can be tailored to the individual patient's condition and needs.