The American Urological Association's handbook is the tool used by Urologists around the world to determine the appropriate treatment options for kidney stones. The AUA guidelines are compiled based on observational studies from around the globe to provide Urologists and patients with the best care possible. Let's dive in and take a look underneath the hood of the process your Urologist goes through when making a recommendation for treatment of your kidney stones.
Percutaneous Nephrolithotomy (PCNL) was first described in 1976 as an operative technique for removing kidney stones through a percutaneous nephrostomy tract that involves an incision into the skin and kidney. Since its introduction, there have been many technological improvements (such as Miniperc and Microperc) over the last few decades that have led to Percutaneous nephrolithotomy (PCNL) becoming one of the cornerstone treatments for large (> 2cm) or staghorn kidney stones.
Ureteroscopy has evolved to be one of the primary treatment options for kidney stones since its introduction in 1964. Ureteroscopy is popular with Urologist when Shockwave Lithotripsy (SWL) fails or there is a complicated ureteral or renal stone and Percutaneous Nephrolithotomy is not an option.
Read more to learn more about this surgical procedure for kidney stones.
Shockwave Lithotripsy (SWL) was first used to treat kidney stones in 1980. This treatment modality uses sound waves to break apart kidney stones so that smaller fragments may pass through the urine. In the 40+ years since its introduction, SWL has become widely popular and is currently one of the first-line options for the non-invasive treatment of kidney stones less than 20mm in diameter without the requirement for general anesthesia. However, due to its incredibly complicated nature and unreliable performance, alternative treatment methods with higher success rates are becoming more prevalent.
Expulsive therapy is a relatively new practice in the conservative management of kidney stones that has evolved along with our understanding of the urinary system. Based on this evolution, two paths of expulsive therapy have evolved to help people pass their kidney stones without the need for surgical intervention. The natural expulsive therapy path harnesses centuries-old herbal medicine with other whole foods while the medical expulsive therapy utilizes pharmaceutical-derived alpha blockers or calcium channel blockers.