Latest treatments for kidney stone now in Oman

Kidney stones are among the most common urological diseases affecting the people of Oman. The range of symptoms varies from back or back to front pain, bleeding with urine, urine infection and voiding difficulties. Occasionally, they may be completely asymptomatic.Kidney stones tend to grow and block the urine drainage from the kidney. In advanced stages, patients may experience kidney failure. Although small kidney stones (smaller than 5-6mm) may pass out spontaneously, larger stones and stones in odd locations in the kidney (lower pole) often demand intervention. The management of kidney stones has considerably changed in recent times.The conventional treatment was ESWL (popularly misnomered here as Laser), whereby the patient lies on a machine and external shock waves are directed to the stone with an objective to break it into pieces that can be expelled spontaneously. Although this is a good modality, the principal problems are its lack of efficacy for hard kidney stones, kidney stones in odd locations and stones with associated kidney blocks. Additionally, the fragmented stones need to be expelled from the body which is not a guaranteed phenomenon.
Large kidney stones were conventionally dealt with open surgery that required a large incision to approach the kidney. This procedure resulted in prolonged suffering and delayed recovery of the patient. The new treatment options aim at managing kidney stones in a less invasive or non-invasive way (minimal suffering to the patient) and ensuring complete clearance. Natural orifice surgery for kidney stones (using the natural urine passage and a special ultrathin flexible instrument) can completely clear stones upto 1.5cm in any pocket of the kidney.Stones of larger size can be cleared by a procedure called PCNL, or keyhole surgery, whereby a small hole is made in the back through which the kidney is entered to fragment the stone and remove it completely. Very large stones or stones with associated kidney blocks can be managed by laparoscopy in which three or four small holes are created in the tummy, the kidney opened and the stone completely removed and the kidney repaired.All these techniques use sophisticated technology and instruments, inflict minimal suffering to the patient and ensure complete clearance of kidney stones. Fortunately, in recent times, all these advanced techniques have been made available in Oman.