According to MSc.BS. CKI Tran Quoc Phong, Head of Urology Unit, An Binh Hospital (HCMC), not all cases of kidney stones require surgical intervention.
Small stones, located in the renal pelvis, that do not cause obstruction, infection or pain and do not increase in size over time can be monitored periodically with ultrasound or other diagnostic imaging methods. However, monitoring is not synonymous with subjectivity. Patients need to re-examine on schedule and go to a medical facility immediately when signs such as back pain, fever, bloody urine, or poor urination appear.
Not just based on the size of the gravel
According to Dr. Phong, the decision to treat kidney stones cannot be based on mere size but needs to comprehensively assess the location, shape, hardness of the stones, water retention, infection, kidney function as well as characteristics of each patient.
Usually, kidney stones under 10 mm and without symptoms can be considered for monitoring. For stones from 10-20 mm, the doctor will choose appropriate methods such as exoskeletal stoning, soft endoscopic stoning or percutaneous stoning. Cases of large stones over 20 mm are often prioritized for percutaneous stoning due to their higher ability to clean stones.
However, even small stones need to be treated early if they cause urinary tract obstruction, infection, prolonged pain or affect kidney function.
Cases where treatment should not be delayed
Urology experts recommend that patients need early intervention when signs such as fever, chills accompanied by urinary tract obstruction appear; prolonged pain that does not respond to medication; progressive hydronephrosis; impaired kidney function; obstruction in people with only one kidney or obstruction on both sides.
In particular, urinary tract infection on a background of stone blockage is an emergency. In this case, the top priority is to drain urine to control infection before treating stones.
Prevention of recurrence of stones
Currently, patients have many treatment options such as external stone removal, urethral endoscopy, soft endoscopy in the kidneys with laser, skin-to-skin stone removal or surgery in special cases.
To limit the risk of recurrence, Dr. Phong recommends that people drink enough water to create about 2-2.5 liters of urine per day, maintain a balanced diet, do not abstain from excessive calcium, reduce salt, limit animal protein, control weight and limit soft drinks. Cases of recurrent stones or with special risk factors should be analyzed for the composition of stones and assessed for metabolic disorders to have appropriate preventive measures.
