Treatment of Kidney Stones
The development of kidney stones (aka urinary calculi) is a common condition seen by family practice doctors, emergency room physicians, and urologists. There are several considerations when treating kidney stones:
1. Most small calculi (< 4mm) pass spontaneously on their own without intervention.
2. Treatment of stones < 4mm consists of pain medication, vigorous hydration, and straining of the urine.
3. Stones larger than 4 mm but less than 2.5 cm are treated by extracorporeal shock-wave lithotripsy (ESWL).
4. Stones larger than 2.5 cm require percutaneous nephrolithotomy (PCNL).
5. Staghorn calculi require PCNL.
6. Stones that do not pass spontaneously typically obstruct the urinary system at three points: the ureteropelvic junction, the area where the ureter crosses the iliac vessels, and the ureterovesical junction.