Urological stones, medically referred to as urolithiasis, are solid concretions or crystals formed in the urinary tract. These stones may develop anywhere in the kidney, ureter, bladder, or urethra, and their presence can lead to significant discomfort, urinary problems, infections, and kidney damage if not treated properly.
This guide will explore in detail the causes, types, symptoms, diagnostic techniques, modern treatment options, and preventive strategies for urological stones.
PCNL is a minimally invasive surgical procedure used to remove large or complex kidney stones (typically >2 cm) directly through a small incision in the back.
Kidney stones larger than 2 cm
Staghorn calculi
Stones resistant to other methods (like ESWL)
Multiple stones in different parts of the kidney
Performed under general anesthesia.
A small (1–2 cm) incision is made in the back to access the kidney.
A nephroscope is inserted into the kidney through a tract created in the skin.
Stones are broken using ultrasound, pneumatic, or laser energy and removed using forceps or suction.
High stone clearance in one sitting
Ideal for large or complex stones
Minimally invasive compared to open surgery
URSL is the procedure of breaking and removing ureteric stones using a rigid or semi-rigid ureteroscope passed through the natural urinary pathway.
Stones located in the ureter (especially mid or lower ureter)
Stones that have not passed spontaneously
Stones causing obstruction or infection
Done under spinal or general anesthesia.
A ureteroscope is inserted through the urethra and bladder into the ureter.
The stone is visualized, fragmented using laser or pneumatic lithotripsy, and the fragments are either removed or left to pass naturally.
A DJ stent may be placed for drainage and to prevent ureteral swelling.
No incision
Short hospital stay
Safe and highly effective
RIRS is a flexible endoscopic procedure to treat stones inside the kidney by approaching them through the urethra and ureter.
Kidney stones < 2 cm
Stones in anatomically difficult areas
Failed ESWL or URSL
A flexible ureteroscope is passed through the urethra into the kidney.
The stones are located under direct vision.
Holmium:YAG laser is used to fragment stones.
Dusting technique may be used (no fragment removal necessary).
A DJ stent is often placed temporarily post-procedure.
Completely incision-free
Precise targeting of stones
Minimal pain and faster recovery
Laser lithotripsy uses laser energy to break urinary stones into fine fragments or dust that can either be removed or passed naturally.
During URSL for ureteric stones
During RIRS for kidney stones
Occasionally in PCNL for hard stones
A laser fiber is inserted through the working channel of an endoscope.
High-energy laser pulses fragment the stone.
Fragmentation modes:
Dusting: turns stones into fine powder
Popcorning: to break down large fragments
Fragment and retrieve
Precise and powerful
Minimal damage to surrounding tissue
Can treat all stone types (calcium, uric acid, cystine)