Abstract

MANAGEMENT OF SMALL SIZE RENAL STONES

Author(s): Manish Jain1, Kshitiz Nath2, Rajat Jain3

AIMS AND OBJECTIVES
To find out the approach and management of small size renal stones.
MATERIAL AND METHODS
A search was performed in 2015, on various guidelines and articles, using the terms renal calculi, 1-2cm, <2cm, PCNL, SWL. Articles were reviewed after determining their relevance for the management of small-sized stones. Cross-references from the articles were also viewed. We reviewed the available literature for the management of lower polar and non-lower polar stones separately because of the reported poor clearance and difficult access for stones in the lower pole.
RESULT AND CONCLUSIONS
Small sized stones less than 5mm should be managed conservatively as they have greater chance to pass out by medical management. Calculi more than 5mm but are less than 1 cm, SWL is the treatment of choice. Stones between 1 to 2cm should be managed according to patient’s preference and his monetary conditions. It also depends on position and type of stone. For stone in upper and middle calyx, SWL should be preferred and for stones in lower calyx, PCNL should be the modality of choice. For stone more than 2cm, PNCL should be preferred or a more invasive method can be opted.