When diagnosed with urinary stones in Seomyeon, many people believe that the size of the stone is everything. However, even stones of the same size can be completely different in whether they can be passed naturally or require treatment depending on their location.
Let's take a look at why size is not important and location is, and how to actually choose a treatment.
How do you know if a kidney stone is moving?
Accurately identifying the signs that a kidney stone is moving is the starting point for determining treatment. If the location and intensity of pain change, it indicates that the stone is shifting, which is a signal that increases the likelihood of natural expulsion.
If pain that starts on one side of the flank moves downward over time, it means there is a possibility that the stone is passing through the urinary tract. On the other hand, if the pain persists in the same area, it means the stone is fixed in the same position, and in this case, natural expulsion is difficult to expect.
Pain often worsens at night because stones are more likely to irritate the ureter when lying down. It is very important to carefully observe these changes in pain patterns.
The reason why treatment methods differ even for the same size
The reason why the location is more important than the size of the stone is simple. This is because the need for treatment is determined by whether the stone is located in an area where it can be naturally expelled or is lodged in a narrow space.
Even small stones of about 4 to 5 mm may not be able to pass on their own if they are lodged precisely in the narrowest part of the ureter. Conversely, there are actually cases where stones larger than 5 mm can be naturally expelled during observation, depending on their location. This is precisely why you cannot judge it by size alone.
If a doctor simply says, "The size is fine, so wait," or "It is large, so treat it quickly," during the initial diagnosis, that judgment alone is insufficient. This is because even stones of the same size must be examined in terms of their location and how much they are moving.
How is kidney stone pain different from muscle pain?
Urinary stones are characterized by severe, squeezing pain that recurs for minutes to hours. This is clearly different from muscle pain.
| division | myalgia | Urinary stone pain |
|---|---|---|
| robbery | dull and persistent | Squeezing intensity |
| pattern | Consistency | Repeats periodically like waves |
| Change in location | Fixed | Gradually moving downward |
| Relief methods | Relief through changes in posture and rest | Not improving with rest |
While muscle pain gradually improves with changes in posture or sufficient rest, the pain from kidney stones is not relieved at all by rest. If such intense and unpredictable pain recurs, it is wise to visit a urologist.
What test can accurately determine the size and location?
Accurately determining the size and location of the stones is key to establishing a treatment plan. This is typically done using a CT scan, which accurately reveals the size, location, shape, and density of the stones.
While ultrasound and standard X-rays are used as supplementary tools, there is no test as reliable as a CT scan for small stones that require precise diagnosis. Based on these test results, the doctor determines whether "observation" or "aggressive treatment" is the appropriate course of action.
Should I wait for it to pass naturally, or get treatment?
This is the choice the patient agonizes over the most. The criteria for judgment are clear. If pain recurs and the stone does not move from the same position for a certain period, natural expulsion is unlikely, and active treatment should be considered.
Conversely, if the pain subsides and the stone is gradually moving down, monitor the progress and focus on management to aid natural expulsion. Adequate fluid intake is key., Drinking more than 2 to 3 liters of water a day is fundamental for natural elimination.no see.
Even if you are being monitored, you must visit a hospital immediately if pain suddenly worsens, is accompanied by fever, or if nausea occurs. This is because a urinary tract infection may be present.
Solving Immobilized Stones with Extracorporeal Shockwave Therapy
Extracorporeal shockwave lithotripsy (ESWL) is a primary treatment option for kidney stones that are difficult to pass naturally due to their location or those that remain immobile for a long period. This method has the advantage of being effective while placing minimal physical burden, requiring little to no anesthesia or hospitalization.
Stones fragmented by extracorporeal shockwave therapy are not removed immediately. Over time, the finely broken stone fragments undergo a process of being expelled from the body along with urine.
The effects should be assessed after a certain period has elapsed, rather than immediately after the procedure, and sufficient fluid intake during this time greatly aids in elimination.
Temporary pain or hematuria may occur after the procedure, but this is a normal reaction. You do not need to worry too much if these symptoms appear. To prevent recurrence, it is important to make it a habit to drink plenty of fluids regularly and to avoid excessive salt, protein intake, and overdose of Vitamin C. Given that the recurrence rate of urinary stones within five years is 501 per 30 days, consistent management in daily life following a medical examination is the true form of prevention.
Ultimately, what should be prioritized?
The best treatment method is determined by comprehensively assessing the size, location, movement of the stone, and the severity of symptoms. However, the most important criteria for judgment are its location and whether it has currently moved.
During a consultation with a doctor, statements such as “It is small, so you don’t need to worry” or “It is large, so treatment is essential” may not be a definitive judgment. We need to examine together where your kidney stone is currently located, whether it is moving, and how the pain is changing.
Urinary stones are a condition that can be approached with sufficient caution unless it is an emergency. Please work with your medical team to make the best decision by focusing on two factors: location rather than size, and changes in pain during observation.