Nephrolithiasis

Most people get their first kidney stone before the age of 50. The lifetime risk of having renal colic is one in ten, and if a patient once has had a stone, the risk of having one more is almost 50%.

Karolinska's urology clinic has been a pioneer in the extracorporeal shock-wave (ESWL) treatment of kidney stones. Under the former professor Hans-Göran Tiselius, the Kidney Stone department of Karolinska University Hospital Huddinge developed into one of the world's leading centers for this treatment modality. In addition to ESWL, we offer endoluminal and percutaneous surgery of kidney and ureter stones, metabolic evaluation, and pharmacologic treatment of patients with recurrent kidney stone disease.

The most prominent symptom is intense pain, urgency, and difficulty voiding. Treatment options for renal colic include medication and placement of a urethral stent or a nephrostomy in the urinary tract. These interventions reduce the risk of having new colic and kidney failure.

Most stones in the urinary tract resolve on their own. However, when the stones are too big or if there are anatomical abnormalities, the stones will not pass. At that stage, active treatment is necessary.

There are three treatment modalities for urolithiasis;

Extracorporeal shock-wave lithotripsy (ESWL)
Endoluminal laser lithotripsy with a ureteroscope (URS and RIRS)
Percutaneous nephrolithotomy (PCNL).

ESWL is the most common and is used for smaller stones (<20 mm) in the urethra and the kidney. URS and RIRS have the same indications, while PCNL is used for bigger kidney stones (>20 mm). ESWL, URS, and RIRS are performed in daytime care. PCNL most often requires an overnight stay in the hospital.

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