- May 19, 2020
- Posted by: Prof Dr Coşkun Şahin
- Category: Kidney Diseases

What are kidney and urinary tract stones?
It is one of the most common diseases that can be seen anywhere in the world, ranging from kidney to outer urinary canal mouth, powder sugar grain to egg size.

Kidney stones broken and collected by surgery (PNL method)
What are the Symptoms of Kidney and Urinary Stones?
It may not give any symptoms. Unbearable pain when burning in the urinary tract, burning, can bleed in the urine. Along with pain, nausea and vomiting may occur. The pain is on the side and can hit the testicle or cervix. It can block the urinary tract completely, causing inability to urinate. It can make a fever infection and kidney failure.
What are the causes of kidney and urinary tract stones?
-Genetic factors
-Nutrition habits
-Life style
-Living in a hot climate -Geographical factors
-Drinking little water -Anatomical structural disorders
What are the Risk Factors of kidney and urinary tract stones?
Familial predisposition, drinking low water, eating foods rich in calcium, low movement bone loss, etc. factors are risk factors.
What are the complications of kidney and urinary tract stones?
If it is not diagnosed and treated early, it can create a clinical condition that leads to kidney loss and kidney failure.
What should be done before the doctor’s appointment?
If available, the examination and radiological imaging methods should be accompanied.
What are the Inspection Methods?
Ultrasonography is the most common and harmless method. It makes a diagnosis of 70-90%. The location and size of the stone can be seen in flat stomach films. Today, we make the most accurate and fast diagnosis with Tomography. Urine analysis urine culture blood biochemistry and pediatric patients are examined in detail. If necessary, 24-hour urine is collected and some substances in the urine are examined.

Direct film of a patient with a large number of stones in both kidneys. This patient is one of the patients we have the most trouble as a doctor.

Stone shown in white in the left kidney.
What are the Treatment Methods?
Do not follow anything: It may be the first choice for stones that have fallen into the channel with a diameter of 3-5 mm. The same is true for stones in the kidney. However, if the patient wants to get rid of the vip staff and the stone as soon as possible, other treatments are started.
ESWL (External shock wave breaking): Applied in kidney and urinary tract stones. Stone size should be less than 2 cm. 1-3 sessions may be required. There should be 1 week between sessions. Some patients may need a tube placed in the urinary canal called a stent. It is not suitable for overweight and high blood pressure patients with stones located on the bottom of the kidney with large stones with bleeding problems.

ESWL treatment is done in 20 minutes sessions. The shock waves sent from an energy source hit the stone, causing it to break.
PNL (Percutaneous stone surgery)
The stone in the kidney is reached by entering a pen-thick hole from the back of the patient lying prone in the operating room, and the stone is broken and the pieces are taken out. It may take 1-3 hours. He is hospitalized for 1 day. 80-90% of the stone is saved. Please click the link for the surgery video.
RIRS (Entering through the Urinary Canal, breaking the kidney stones with laser)
This method has become popular in recent years. It is done in the operating room. By entering through the natural cavities of the body (urinary canal), the kidney is reached and the stones are broken into powder under direct vision with holmium laser. The patient spills his own stones and is sometimes collected by the physician. The process may take 1-3 hours. Stents can be placed during the procedure. He is hospitalized for 1 day and discharged.
Open Surgery:
It is rarely done today. Open surgery may be an option if there is urinary tract stenosis that requires repair together or if the stone fills the entire kidney.
Which method is better?
The most important factor that determines this is the possibilities at hand, the experience of the urologist, the patient’s expectation and cost. The cheapest method is the ESWL method. The chance of getting rid of the stone varies between 30 and 100%. Requires session. There is no guarantee of exact breaking. Even if it is broken, the stone may not fall. It may require a secondary surgery. The PNL (surgical technique through the hole through the back) gives very good results in suitable patients. It can be completely removed from the stone. However, if the stones are very scattered, the patient may remain in the stone after the procedure. These remaining stones can be broken with ESWL. RIRS, that is, entering the urinary canal, and breaking the stone with laser does not disrupt body integrity, has become popular today. Surgery is performed by entering through the urinary canal. It is the first treatment considered in patients with bleeding problems.
How do we do it?
First of all, we reveal the stones of the patient with the most modern imaging methods. We consider the surgeries it has undergone and the applications it has undergone. We question the patient’s expectations, profession, lifestyle, and we determine the most appropriate method for that patient. We have the opportunity to apply all modern techniques applied to stone in the world.
You can ask to Prof. Dr. Coşkun Şahin about your Diseases, Surgeries and Prices.
Life Style Advice
2.5 lt of water should be drunk daily for life. Diet should be observed. An active life should be chosen. It should not sweat excessively. Regular checks should be made. It should be fed a diet that is poor in oxalate.