Renal and Ureteric Calculi
Treatment of renal and ureteric calculi remains an important task for the practising urologist.
Stones can be various types, sizes and patients have different risk factors for stone formation and stone recurrence. These can be discussed with you during your consultation.
In the first instance the management of ureteric stones includes pain control and relief of the obstructed kidney. This part is essential because it relieves the pain and minimises the risk of infection from a blocked kidney. The way to do that is by bypassing the stone with a stent. The stent is a rubbery tube with a small diameter, one end of it stays in the kidney, the mid portion is in the ureter and the other end is in the bladder. Insertion of a stent is a procedure performed under general anaesthetic.
Subsequent procedures will follow to treat your stone. These also vary depending on the size of the stone, its location, patient and surgeon factors.
The least invasive approach is shockwave therapy (ESWL). ESWL is currently not available in South Australia. Not all stones or patients are suitable for that treatment.
The majority of ureteric or kidney stones are currently treated using laser to break the stones to fine dust and small fragments which the patient subsequently passes. This surgery is performed with fine instruments using the natural urinary passages. No cutting is involved.
Percutaneous Nephrolithotomy (PCNL) is used in suitable patients with large stone burden. The kidney stones are extracted by creating a tract/passage from the skin to the kidney. This approach is quite effective but has more potential side effects and the access to the kidney can be difficult.
In rare cases open surgery is still reserved for patients with complex stone burden, stones in difficult locations or challenging renal anatomy.
Dr Penkoff is experienced at all approaches and will discuss the details in your particular situation.