The treatment of renal calculi might include

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The goals of medical care are to remove the calculi, treat pain and infection, and resolve causative factors. These measures should prevent permanent kidney damage and recurrence of calculi. The treatment begins with analgesic therapy and hydration during the initial evaluation. Location and size of the calculi indicate the course of treatment. Small calculi (<5 mm) may be treated by observation and with fluid hydration in the hope that the stone will pass spontaneously. Large calculi can be removed by any of several surgical procedures. Attempts are made to crush stones that are (1) too large to pass down the ureter, (2) lodged in the pelvis of the kidney, or (3) trapped in the proximal portion of the ureter. Extracorporeal shock wave lithotripsy (ESWL) is a procedure that breaks apart (crushes) the stones, thus allowing the small particles to flush out of the body naturally. A surgical procedure using an ureteroscope to capture the stone in a basket and remove it is attempted for stones trapped in the distal aspect of a ureter. If the attempt to capture the stone is unsuccessful, electrohydraulic lithotripsy (EHL) or laser lithotripsy is used in an attempt to break the stone apart into small particles that can be flushed out of the system. This procedure usually is done with the patient under general anesthetic and with the aid of fluoroscopy. After removal of the calculus, the ureter is visualized via the ureteroscope, and often the pelvis of the kidney is also inspected for any scarring, damage, or residual stone fragments. A stent that extends into the urinary bladder is placed in the pelvis of the kidney as a means of preventing edema and spasms of the ureter and subsequent occlusion of the ureter. The stent is removed in 2-5 days. Stones in the urinary bladder often pass spontaneously. When this does not happen, an attempt to remove bladder stones is done during cystoscopy. When previously mentioned procedures are unsuccessful in removing the calculi, surgical intervention in the form of percutaneous nephrolithotomy may be indicated to remove the stones before permanent damage is caused. A small incision is made into the kidney, and the stone is shattered by ultrasound or EHL. Rarely, when the aforementioned procedures are unsuccessful, surgical incision of the kidney is performed to remove the stone. Depending on the chemical composition, some kidney stones can be dissolved or prevented from forming. Often the patient may pass small or microscopic stones naturally and without pain. The patient is encouraged to drink 8-12 glasses of water a day and may be given diuretics to prevent urinary stasis. Patients are encouraged to strain their urine to catch any stones or particles of stones that may be passed spontaneously. In that way, analysis of the calculi composition is made possible, which can help direct preventive measures.

The Treatment of Renal Calculi Might Include