A patient diagnosed with acute kidney injury presented with large stones in both ureters, causing severe obstruction and preventing normal urine flow. He initially visited a tertiary hospital in an emergency setting, but treatment was delayed due to a backlog in surgical scheduling. He was subsequently treated with endoscopic surgery. The stone in the right ureter was rapidly removed using a rigid ureteroscope, while the left upper ureteral stone was successfully treated using a flexible ureteroscope. Through this advanced, high-complexity procedure, the patient was able to avoid severe kidney damage and recover his health.
Urinary stones (urolithiasis) are a condition in which stones form in the kidneys and move through the ureters, often causing severe pain. The pain is typically intense and can be debilitating, leading many patients to seek urgent medical care. During the summer, the risk of stone formation increases due to dehydration and concentrated urine caused by excessive sweating. Small stones may pass spontaneously through urination, but larger stones can cause severe pain and obstruct the ureter, disrupting urine flow.
In emergency situations like this case, patients with urinary stones often present with severe pain. When patients visit the emergency department with intolerable pain, immediate surgery may not always be feasible. In such cases, temporary measures such as percutaneous nephrostomy may be performed to relieve pain and stabilize the patient. This procedure helps restore urine flow from the kidney to the outside of the body, improving the patient’s condition. However, it does not address the underlying cause—the stone itself.
The choice of treatment for urinary stones depends on their size and location. In many cases, extracorporeal shock wave lithotripsy (ESWL) is attempted first. However, some stones cannot be effectively treated with ESWL. Stones located in difficult anatomical positions, very large or very small stones, or multiple stones often require endoscopic surgery. Rigid ureteroscopy is typically used for stones located in the lower ureter, while flexible ureteroscopy is more suitable for stones in the kidney and upper ureter. These procedures require a high level of precision and surgical expertise. Although complications such as ureteral injury can occur, experienced medical teams are well-equipped to manage and minimize these risks.
When selecting a hospital for urinary stone treatment, several factors should be considered. First, the availability of advanced equipment and modern treatment technologies is essential. Second, the experience and expertise of the medical team play a critical role in managing complex cases safely. Third, adequate facilities for preoperative and postoperative care, including comfortable recovery spaces for patients and caregivers, are important for overall treatment experience.
In summary, urinary stones require prompt diagnosis and appropriate treatment. Timely intervention can prevent kidney damage and effectively relieve pain. If urinary stones are suspected, it is important to seek evaluation at a specialized medical facility without delay. In some cases, large stones discovered incidentally without symptoms may already have caused significant kidney damage, which can be irreversible. Therefore, early and appropriate treatment is essential to preserve kidney function and maintain long-term health.