Kidney Stone Treatment (Laser, PCNL and Shock Wave Therapy)

People who've had kidney stone pain often call it the worst pain of their life. It comes in waves, starting in the back or side under the ribs and shooting down to the groin, and no position makes it better. Vomiting, blood in the urine and a constant urge to pass urine are common. Hot summers, long hours without water and a salty diet make stones especially common in north India.

Stones form when minerals in concentrated urine crystallise, most often as calcium oxalate. Small ones pass down the ureter (the tube from kidney to bladder) on their own. Larger ones get stuck, block the kidney or keep growing silently. Kidney stone treatment has four main options. In order of how invasive they are: tablets that help a stone pass, shock waves from outside the body (ESWL), a thin telescope passed up to the stone so a laser can break it (ureteroscopy), and keyhole removal through the back for large stones (PCNL, percutaneous nephrolithotomy).

With the right choice, most people become stone-free after one procedure, though a large stone sometimes needs a second sitting. Keeping stones away is the harder part: about half of people who have one stone form another within 5 to 10 years unless they change how much they drink and eat.

Our urology department uses imaging to work out each stone's size, position and likely composition, then chooses the least invasive treatment that will work: medical expulsion therapy for small stones, shock wave therapy, ureteroscopy with laser lithotripsy, or PCNL for large stones. Dr. Prabhat Ranjan, our urologist, performs PCNL and ureteroscopy.

Not every stone needs a procedure. An ultrasound or a low-dose CT scan (the most accurate test) shows the stone's size and position and whether the kidney is blocked.