Hi,
The treatment of kidney stone depends on your symptoms, size and location. Asymptomatic calculi, less than or equal to 5 mm can usually be managed by medical therapy (eg.
potassium citrate syrup,
febuxostat, thiazide etc).
ESWL is good for a single stone between size 5 to 10 mm. Since shockwaves have to pass through the kidney to break the stones, there is a limit to the number of shockwaves that a kidney can tolerate. Moreover, small stones are difficult to localize in
fluoroscopy or
ultrasound during ESWL. Thus, ESWL is a very poor choice for multiple small stones.
For multiple small stones, current treatment of choice is flexible ureteroscopy with laser. In this procedure, the surgeon can see inside the kidney and treat each and every stone with laser. Thus, clearance rates are very good. However, its availability is limited to a few centers.
In your case, if you do not have any symptoms, I advise you to start medical therapy after undergoing a 24 hour urine metabolic work up (Check urine volume, pH, creatinine, calcium, phosphorus, sodium, uric acid,
oxalate, citrate and
magnesium) along with
serum creatinine, calcium, uric acid and electrolytes. These tests will help to find out the reason for formation of kidney stones. Accordingly, individualized medical therapy can be advised to dissolve current stones and prevent future stones.
General measures to treat kidney stones are to keep urine output more than 2.5 liters per day, reduce salt intake less than 5 g/day and reduce animal protein intake.
I hope I have answered your query. If you need any clarification, please feel free to contact me.
Wish you good health,
Warm regards,
Dr. Raguram G MCh (Uro), F. Endouro.
AUKI