KIDNEY STONES TREATMENT IN NIGERIA
In Recent times, Kidney stones treatment in Nigeria has become one of the most prominent searches on the internet. What is Kidney stones?
Kidney stones are hard deposits that form when minerals and other substances in urine become concentrated and crystallize. A stone may remain inside the kidney or move into the ureter, the narrow tube connecting the kidney to the bladder.
Small kidney stones may sometimes pass naturally through the urinary tract. Larger stones, stones causing obstruction, or stones associated with infection may require medical or surgical treatment.
Common symptoms include:
- Severe pain in the side or lower back
- Pain that may radiate toward the abdomen or groin
- Blood in the urine
- Painful urination
- Frequent or urgent urination
- Nausea and vomiting
- Difficulty passing urine
- Fever or chills when infection is present
Not every kidney stone requires surgery. A urologist should assess the patient and determine the most appropriate treatment.
How Are Kidney Stones Diagnosed?
Before deciding on treatment, a urologist usually needs to determine the stone’s size, location and characteristics.
Depending on the individual case, investigations may include:
- Urinalysis
- Blood tests
- Kidney function tests
- Ultrasound
- X-ray
- CT scan
- Stone analysis
- Metabolic evaluation
- 24-hour urine testing in selected patients
The information obtained from these investigations helps the urologist determine whether observation, medication, stone fragmentation or surgical removal is appropriate.
Treatment Options for Kidney Stones in Nigeria
Modern kidney stone treatment in Nigeria can include observation, medication, shock-wave treatment and minimally invasive surgery.
The treatment selected depends on factors such as:
- Stone size
- Stone location
- Stone composition
- Degree of urinary obstruction
- Presence of infection
- Kidney function
- Previous treatment
- Patient symptoms
- Overall health
1. Observation and Active Surveillance
Very small kidney stones ie stones less than 5mm in diameter may pass naturally without any issues. When a stone is unlikely to cause significant obstruction or complications, a urologist may recommend monitoring it.
During observation, the patient may be advised to:
- Drink an appropriate amount of water
- Take prescribed pain medication
- Monitor symptoms
- Attend follow-up appointments
- Repeat imaging when recommended
However, patients should not assume that every stone will pass naturally. A stone that remains in the urinary tract, causes obstruction or produces recurrent symptoms may eventually require intervention.
2. Medical Treatment to Help a Stone Pass
Certain patients may receive medication to facilitate the passage of a ureteric stone.
For example, medications such as alpha-blockers may be considered in selected patients because they can relax the ureter and the collecting system of the kidney and potentially assist stone passage.
However, medication is not suitable for every stone. The decision depends on the stone’s size, location and the patient’s clinical condition.
Medication may also be used to manage pain, nausea or other symptoms while the stone is being monitored.
Patients should not take prescription medicines for kidney stones without assessment by the Urologist.
3. Extracorporeal Shock Wave Lithotripsy (ESWL)
Extracorporeal Shock Wave Lithotripsy, commonly called ESWL, uses externally generated shock waves to break a kidney stone into smaller fragments.
The smaller fragments can then pass through the urinary tract. ESWL may be considered for selected stones depending on their:
- Size
- Location
- Density
- Composition
- Relationship to surrounding structures
One advantage is that ESWL does not require an incision into the body.
However, ESWL is not appropriate for every patient or every stone. Some stones are too large, too hard or located in a position where another procedure may provide a more suitable solution.
A urologist should therefore determine whether ESWL is appropriate.
4. Semi Rigid Ureterorenoscopy (URS)
Uses a semi rigid instrument that can travel through the urinary tract and reach as far as the renal pelvis.
This allows the urologist to visualize and treat stones located along the ureter. Once a stone is identified, LASER or pneumatic energy can be used to break the stones and flush them out.
The procedure is minimally invasive and may be used as part of an individualized treatment plan for selected kidney stones.
5. Retrograde Intrarenal Surgery (RIRS)
Retrograde Intrarenal Surgery (RIRS) is an advanced minimally invasive approach for treating stones inside the kidney.
During RIRS, the urologist accesses the kidney through the natural urinary passage using a flexible ureteroscope. Laser energy can then be used to fragment the stones.
RIRS can provide direct access to stones within the kidney without creating a traditional surgical opening through the skin.
6. Percutaneous Nephrolithotomy (PCNL)
Percutaneous Nephrolithotomy (PCNL) is a minimally invasive surgical procedure commonly used for larger or complex kidney stones. Typically stones that are more than 2cm in diameter.
Instead of reaching the kidney through the urinary passage, the surgeon creates a small access tract through the skin into the kidney. Specialized instruments are then used to break up and remove the stone.
PCNL can be particularly useful for large stone burdens where other procedures are less suitable.
7. Mini-PCNL
Mini-percutaneous nephrolithotomy, commonly called mini-PCNL, uses a smaller access tract compared with conventional PCNL.
It can be considered for selected patients depending on the size, location and characteristics of the kidney stone.
The appropriate procedure should always be determined after imaging and specialist assessment.
8. Open Stone Surgery
Open surgery was historically used more frequently for kidney stones, but advances in endoscopic and minimally invasive techniques have significantly expanded the alternatives available to patients.
Today, many patients can be treated using procedures such as ureteroscopy, laser lithotripsy, RIRS or PCNL.
Open surgery is only used these days in places where equipments or skills for the more modern procedures are not available.
When Does a Kidney Stone Need Surgery?
Not every kidney stone requires an operation.
Surgical or procedural treatment may be considered when:
- The stone is large
- The stone is causing persistent pain
- The stone is blocking urine flow
- The stone is not passing naturally
- There is recurrent urinary tract infection
- Kidney function is threatened
- The stone continues to grow
- The patient has repeated episodes of symptoms
- Previous conservative treatment has failed
A urologist will consider the patient’s symptoms, imaging results and overall health before recommending a procedure.
Kidney Stone Treatment at Eleos Specialist Hospital
At Eleos Specialist Hospital, we provide specialized kidney stone treatments.
Our current services for kidney, ureteric and bladder stones include:
- Laser lithotripsy
- Pneumatic lithotripsy
- Semi Rigid ureterorenoscopy(URS)
- RIRS
- PCNL
- Mini-PCNL
- Laser fragmentation of kidney, bladder and ureteric stones
Is Laser Kidney Stone Treatment Safe?
Laser lithotripsy is a widely used minimally invasive technique for treating urinary stones.
However, like every medical procedure, it has potential risks and should be performed following appropriate assessment by a qualified urologist.
Possible complications can include bleeding, infection, ureteric injury, residual stone fragments and the need for additional treatment.
The benefits and risks should be discussed during consultation.
What Happens After Kidney Stone Removal?
Removing a kidney stone does not necessarily mean that another stone will never form.
Some patients are prone to recurrent stones. After treatment, the urologist may recommend:
- Increased fluid intake
- Dietary adjustments
- Stone analysis
- Blood tests
- Urine testing
- 24-hour urine collection
- Medication to reduce recurrence in selected patients
- Follow-up imaging
The preventive strategy should be based on the patient’s individual risk factors.
How Can Kidney Stones Be Prevented?
Adequate fluid intake is one of the most important general measures for reducing the risk of recurrent stones.
Depending on the type of stone, doctors may also recommend:
- Reducing excessive salt intake
- Maintaining an appropriate dietary calcium intake
- Limiting excessive animal protein
- Increasing appropriate sources of dietary citrate
- Maintaining a healthy body weight
- Treating metabolic conditions that contribute to stone formation
Patients who repeatedly develop kidney stones may benefit from a metabolic evaluation to identify why the stones are forming.
When Should You See a Urologist?
You should seek medical attention if you have symptoms suggestive of a kidney stone, especially severe or persistent pain.
Urgent medical assessment is particularly important if kidney stone symptoms occur together with:
- Fever
- Chills
- Vomiting
- Difficulty passing urine
- Severe or worsening pain
- Blood in the urine
- Known urinary obstruction
- A single functioning kidney
- Known kidney disease
A blocked urinary system combined with infection can require urgent treatment.
Frequently Asked Questions About Kidney Stone Treatment in Nigeria
What is the best treatment for kidney stones?
There is no single treatment that is best for every kidney stone. The appropriate option depends on the stone’s size, location, composition, symptoms and the patient’s overall health. Options may include observation, medication, ESWL, ureteroscopy, laser lithotripsy, RIRS, PCNL or mini-PCNL.
Can kidney stones be treated without surgery?
Yes. Some small stones can pass naturally, and selected patients may receive medication to assist stone passage. However, larger stones, obstructing stones, infected stones or stones causing persistent symptoms will require a procedure.
What is laser lithotripsy?
Laser lithotripsy is a minimally invasive procedure that uses laser energy to break a urinary stone into smaller fragments. The procedure is commonly performed using an endoscope passed through the urinary tract.
Can large kidney stones be removed with laser treatment?
Some kidney stones can be treated using laser techniques, but very large or complex stones may require PCNL or another approach. The urologist determines the most appropriate procedure after imaging and assessment.
Is PCNL used for large kidney stones?
Yes. PCNL is a minimally invasive procedure commonly used for larger or complex kidney stones. Eleos Specialist Hospital provides PCNL and mini-PCNL among its kidney stone treatment services.
How do I know which kidney stone treatment I need?
The best way to determine the appropriate treatment is to consult a urologist. Imaging can establish the stone’s size and location, while other investigations can help determine kidney function and other relevant factors.
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