How Do Kidney Stones and Ureteral Stones Affect Your Life?

Kidney stones are one of the most common urological conditions in the general population. They are more common in regions with hot climates, such as Turkey, and in populations with a genetic predisposition. Studies show that approximately 10% of men and 5% of women experiencekidney stonesat some point in their lives.

Stones can form in the kidney or travel down into the urinary tract (ureter), where they can forma ureteral stone. A stone that may remain asymptomatic in the kidney can cause severe flank pain, nausea, vomiting, and a burning sensation during urination once it moves into the ureter. Patients often describe this as “the most severe pain I’ve ever experienced.”

If the stones are left untreated:

  • Permanent kidney damage may occur,
  • Recurrent urinary tract infections may develop,
  • In fact, the kidney may lose its function entirely.

In this article, we will discuss in detailthe causes, clinical symptoms, diagnostic methods, and modernminimally invasive stone surgery options(PNL, RIRS, URS, ESWL)for kidney and ureteral stones. Drawing on the clinical experienceof Prof. Dr. Volkan İzol, we will answer the questions patients often ask in clear, easy-to-understand language.

Causes of Kidney and Ureter Stones

The formation of kidney stonesandureteral stonesis primarily due to the crystallization and aggregation of substances such as calcium, oxalate, and uric acid that are present in urine in a dissolved state.

Risk Factors:

  • Genetic Predisposition:The risk increases if there is a family history of kidney stones.
  • Insufficient Fluid Intake:Kidney stones are more likely to form in people who do not drink 1.5–2 liters of water a day.
  • Dietary Habits:Excessive consumption of salt, red meat, protein, and oxalates (spinach, tea).
  • Metabolic Disorders:Gout, hyperparathyroidism, obesity.
  • Urinary Tract Infections:Infection stones.
  • Hot Climate:Since fluid loss through sweating increases, kidney stone formation is more likely.

Prof. Dr. Volkan İzol emphasizes, in particular, the importance of water consumption:

“Drinking at least 2–2.5 liters of water a day is the simplest and most effective way to prevent kidney stones. For most of my patients, low fluid intake is the most significant risk factor.”

Clinical Findings of Kidney and Ureter Stones

Kidney stonesdo not always cause symptoms. However, whena stoneis inthe ureter, the classic symptoms appear:

  • Flank Pain (Renal Colic):Severe pain that typically radiates from the side of the lower back toward the groin.
  • Nausea and Vomiting:These symptoms occur along with pain.
  • Blood in the Urine:Urine that appears pink or red.
  • Frequent Urination:As the stone approaches the bladder, the urge to urinate increases.
  • Inability to Urinate:If the blockage is complete, emergency treatment is required.
  • Ateş:If a urinary tract infection develops, it can be life-threatening.

Patients experiencing these symptoms should see a urologist without delay. If treatment is delayed, kidney damage may occur.

Diagnostic Methods

The most important step in diagnosis is imaging:

  • Ultrasound:The first step—simple and fast.
  • Direct Urinary Tract X-ray:Visualization of stones via X-ray.
  • Computed Tomography (CT):It is the gold standard; it clearly determines the size, location, and density of the stone.

Treatment is planned accordingly.

Laparoscopic Stone Surgery: Modern Solutions

Today, open surgery has been virtually abandoned. All stone surgeries are performed using“minimally invasive stone surgery.”

  1. PNL (Percutaneous Nephrolithotomy)

PCNL is the gold standard for large kidney stones (over 2 cm). A small incision is made in the back, access is gained to the kidney, and the stones are碎石and removed.

Advantages:

  • Removal of large stones in a single session.
  • The hospital stay is usually 2–3 days.
  • Significantly less scarring and faster recovery compared to open surgery.

Side Effects:Bleeding, infection, and, rarely, injury to adjacent organs. The risk is low when performed by an experienced practitioner.

Early Discharge:With new techniques such as mini-PNL and micro-PNL, patients can be discharged within 24–48 hours.

  1. URS (Ureteroscopy)

In this method used to treat ureteral stones, the surgeon enters through the urinary tract and, after directly visualizing the stone, breaks it up with a laser.

  • It is the first choice for stones measuring 5–10 mm.
  • It is performed under general or spinal anesthesia.
  • Patients are usually discharged the same day or the next day.

Side Effects:Temporary burning sensation, frequent urination, and, rarely, ureteral stricture.

3. RIRS (Retrograde Intrarenal Surgery) – Detailed Explanation

RIRS (Retrograde Intrarenal Surgery) is one of the most commonly used minimally invasive surgical methods for treating kidney stones today. This method allows access through the urethra to the bladder and from there through the ureter into the kidney. Using a device calleda flexible ureteroscope, surgeons can access all chambers of the kidney, where stones are碎 into powder using a holmium laser.

How Is RIRS Performed?

  1. Closed and Incision-Free Access:No incision is made in the abdomen. Access is gained endoscopically through the urethra.
  2. Visualization of the Stone:A flexible ureteroscope is advanced into the kidney, and the stone is directly visible.
  3. Laser Fragmentation:The stone is broken down into small pieces—and practically turned into dust—using a holmium laser.
  4. Removal of Particles:Larger particles can be removed with a stone basket; the powdery portion is naturally excreted in the urine.
  5. Temporary Drainage:If necessary, a “double-J stent” is placed in the ureter to ensure the kidney functions properly. This stent is usually easily removed in an outpatient setting after 1–2 weeks.

Advantages of RIRS

  • Completely Closed:There are no incisions or stitches in the abdomen. This offers significant cosmetic advantages.
  • Pain Is Minimal:Pain is usually mild and can be easily managed with pain relievers.
  • Rapid Recovery and Early Discharge:Patients are usually discharged the same day or the next day. Lost work time is very low.
  • Access to the Entire Kidney:Even stones in the lower calyces of the kidney—which are among the most difficult to reach—can be treated using a flexible ureteroscope.
  • Effective for Recurrent Stones:It can be safely administered even in patients who have previously undergone surgery.
  • High Stone-Free Rate:The success rate is over 90%—especially for stones smaller than 2 cm.

The Post-RIRS Process

  • Catheter:In most patients, the catheter is removed the same day or the next day.
  • Return to Daily Life:You can return to your normal routine within 2–3 days.
  • Side Effects:Temporary burning during urination, slight bleeding, and frequent urination may occur; these symptoms usually disappear within 1 week.

Who Is It For?

  • Kidney stones smaller than 2 cm
  • Patients with multiple stones who do not wish to undergo open surgery
  • Patients who are not suitable for PNL (Percutaneous Nephrolithotomy) or who are at high risk of bleeding
  • Patients with one kidney

Commentary by Prof. Dr. Volkan İzol

Prof. Dr. Volkan İzol highlights RIRS, particularly in terms of patient comfort:

“RIRS is a revolutionary method for the minimally invasive treatment of kidney stones in modern urology. Most of our patients are up and about the same day after surgery and are discharged the next day. It is one of the least traumatic and fastest-healing methods in minimally invasive stone surgery.”

RIRS and Re-mineralization

Following treatment, the stone is analyzed, and the patient is given recommendations to prevent stone formation. The risk of recurrent stone formation is reduced through dietary adjustments (salt restriction, drinking plenty of water) and metabolic evaluation.

  1. ESWL (Shock Wave Therapy)

Stones are broken using sound waves transmitted from outside the body.

  • For small stones, it is a non-surgical option.
  • However, it may not be suitable for all types of stone (high-density stones do not break).
  • More than one session may be necessary.

Postoperative Recovery and Early Discharge

Thanks to modern minimally invasive surgical techniques, patients are back on their feet in no time:

  • Discharge 2–3 days after PNL, or 24–48 hours after mini-PNL.
  • Most patients return home the same day after URS and RIRS.
  • The return-to-work period is limited to a few days.

This rapid recovery allows patients to return to their daily lives in a short time.

Side Effects and Complications

As with any surgical procedure, minimally invasive stone surgery may haveside effects.

  • Temporary burning sensation when urinating
  • Light bleeding
  • Fever or urinary tract infection
  • Ureteral stricture is very rare

With an experienced urology team and the appropriate equipment, the incidence of these complications is very low.

Prof. Dr. Volkan İzol’s Approach

Prof. Dr. Volkan İzol, who offers his patients all the benefits of modern urology in Adana, has extensive experience in minimally invasive stone surgery.
In his private practice, he develops personalized treatment plans for his patients:

  • The size and location of the rock
  • Anatomy of the Kidney
  • The patient's overall health

Based on this, he selects the most appropriateclosed stone surgerytechnique.

Conclusions and Recommendations

Kidney stonesandureteral stones are serious health problems that can lead to kidney damage if not treated in a timely manner.
Today, open surgery has been completely replaced byminimally invasive stone surgerytechniques. Thanks toPNL,RIRS,URS, andESWL, not only is the stone-free rate very high, butearly dischargeis also possible.

Prof. Dr. Volkan İzol emphasizes the importance of early diagnosis and the correct surgical approach in the treatment of kidney stones:

“Today, stone surgery is no longer a process that confines patients to bed and requires weeks of recovery. With minimally invasive techniques, our patients are able to recover both comfortably and quickly.”