As the weather becomes warmer and temperatures rise, more people visit emergency rooms with severe flank pain. In many cases, the cause is urinary stones. Urinary stones form within the urinary tract—including the kidneys, ureters, and bladder—and as they move through the urinary system, they can cause intense pain, inflammation, and even impaired kidney function. During hot weather, fluid loss through sweating increases urine concentration, which significantly raises the risk of stone formation.
The pain caused by urinary stones often occurs suddenly and can be extremely severe. Patients frequently visit the emergency room with flank pain that appears at any time of day or night, often accompanied by hematuria (blood in the urine), vomiting, or fever. When a stone blocks the ureter, urine may flow backward into the kidney, increasing pressure inside the kidney and potentially leading to complications such as hydronephrosis or acute kidney failure. For this reason, prompt diagnosis and treatment are essential.
For many years, the standard treatment for urinary stones has been extracorporeal shock wave lithotripsy (ESWL). This method uses shock waves generated outside the body to break the stone into smaller fragments so they can pass naturally through the urinary tract. Although it is non-invasive, the shock waves may not always reach the stone effectively depending on its size or location. In addition, many patients require repeated treatments—often two or three sessions on average. As the number of treatments increases, so do the time required and the physical and psychological burden on the patient. Furthermore, ESWL has limitations when treating large stones, very hard stones, or stones located in difficult areas such as the upper ureter.
To overcome these limitations, endoscopic surgery for urinary stones has recently become more widely used. Among these techniques, suction-assisted ureteroscopic stone removal is considered a more advanced form compared with traditional rigid ureteroscopy or flexible endoscopic surgery.
This procedure uses a flexible ureteroscope to identify stones inside the kidney or upper ureter. The stones are fragmented using a holmium laser and then immediately removed through a micro-suction device. Because the fragments are removed directly rather than waiting for them to pass naturally, the procedure reduces pain, inflammation, and the likelihood of repeat treatment. Additional benefits include shorter surgery time, reduced hospital stays, and faster recovery.
Many patients feel anxious when they hear the word “surgery.” However, endoscopic stone removal is considered a relatively routine procedure, similar in concept to removing polyps during a colonoscopy. It is typically performed under local anesthesia or sedation. In situations where shock wave therapy is ineffective or when kidney function is at risk, endoscopic surgery is often regarded as the fastest and most definitive treatment option.
Another important point to remember is that urinary stones are not simply a one-time condition. Statistically, the recurrence rate is approximately 7% within one year and exceeds 50% within ten years. In addition, the average daily sodium intake among Koreans is about 1.5 times higher than the level recommended by the World Health Organization (WHO), creating conditions that favor stone formation. Diets high in animal protein, insufficient water intake, and a preference for salty foods are all major contributing factors.
Therefore, even after surgery, lifestyle management remains essential. Drinking sufficient water (at least two liters per day), reducing sodium intake, and avoiding excessive consumption of meat are important preventive measures.
Urinary stones can occur without warning. If severe pain develops—especially during nighttime hours—prompt evaluation and pain management are necessary. Patients with a history of urinary stones are advised to identify nearby hospitals that provide 24-hour treatment for urinary stones in advance. Suction-assisted ureteroscopic surgery is emerging as a new paradigm in the treatment of urinary stones and may be an excellent option for patients seeking more precise and faster treatment.