How Are Kidney Stones Removed with Endoscopic Surgery? Procedure Explained

Hello, this is Dr. Kyungho Ryu from Goldman Urology Clinic, Gangnam.

I understand that you may be experiencing significant discomfort in your daily life due to the sudden and severe pain caused by urinary stones. It appears that you are carefully considering the most appropriate treatment option, including endoscopic stone removal, based on your current condition.

If the pain is recurring and not adequately controlled with medication, it is important to focus on active treatment to prevent complications such as deterioration of kidney function.

When a stone blocks the ureter, it can cause severe pain due to swelling of the kidney.

If the stone is larger than 5 mm, the likelihood of spontaneous passage decreases, making it necessary to accurately determine its size and location through proper evaluation.

Depending on the size and composition of the stone, treatment options such as extracorporeal shock wave lithotripsy (ESWL) or ureteroscopic surgery may be recommended. We advise visiting a urology clinic for appropriate diagnosis and treatment planning.

The symptoms of urinary stones may vary depending on the size and location of the stone.

Typically, sharp, stabbing flank pain that lasts from minutes to hours and then subsides is one of the most common symptoms.

Early diagnosis and treatment are essential. If left untreated, urinary stones may lead to complications such as reduced kidney function, so prompt treatment is strongly recommended.

✅ What is a urinary stone?

Urinary stones are formed when substances in the urine crystallize and harden into stone-like structures in the kidney. As these stones move along the urinary tract, they can cause severe pain.

Reduced fluid intake increases the risk by allowing crystals to remain in the urine longer. A family history, dietary habits, and lifestyle factors can also contribute. One of the main challenges of urinary stones is both the intensity of pain and the high recurrence rate.

✅ Common symptoms

✔ Severe, stabbing pain in the flank or lower abdomen

✔ Hematuria (visible or microscopic blood in the urine)

✔ Urinary frequency, painful urination, or a sensation of incomplete emptying (especially when bladder stones are present)

✔ Fever and chills (may indicate infection and require urgent care)

✅ Causes and risk factors

✔ Insufficient fluid intake leading to reduced urine volume

✔ Dietary habits such as high salt intake or excessive animal protein consumption, increasing the risk of uric acid or calcium stones

✔ Metabolic conditions such as obesity, hypertension, and diabetes

✔ Genetic predisposition, especially with a family history of urinary stones

✅ Diagnosis and treatment based on stone size

To accurately assess the condition, tests such as urinalysis, X-ray imaging, ultrasound, or intravenous pyelography may be used to determine the exact location of the stone.

✔ ≤ 5 mm: natural passage may be attempted with hydration and medication

✔ ≥ 6 mm: lower likelihood of passage → procedural removal such as ESWL is recommended

✔ ≥ 1 cm: larger or harder stones may require ureteroscopic surgery

✔ Extracorporeal Shock Wave Lithotripsy (ESWL)

A non-invasive method that uses high-energy shock waves to break stones into smaller fragments. It can be performed without anesthesia or hospitalization, and newer devices help reduce discomfort during treatment.

✔ Ureteroscopy and robotic-assisted surgery

An endoscope is inserted into the ureter to directly fragment and remove stones. This approach allows complete removal even in cases where ESWL is not effective. Advanced systems improve precision, safety, and treatment efficiency.

✅ Lifestyle management and prevention

✔ To prevent recurrence, it is important to drink at least 2 liters of water per day to dilute urine and reduce stone formation

✔ Reduce salt and animal protein intake

✔ Maintain regular physical activity such as walking, jogging, or light jumping exercises to support urinary tract health and help the passage of small stones

Maintaining adequate hydration, controlling dietary habits, and engaging in regular exercise are essential for preventing urinary stones.

Because urinary stones can cause sudden and severe pain, our clinic operates a 24-hour emergency care system across all branches to ensure prompt treatment whenever needed.

At Goldman Urology Clinic, we carefully assess each patient’s symptoms and overall health condition based on extensive clinical experience, providing an accurate diagnosis and personalized treatment plan.

Identifying the exact cause is the first step toward effective treatment.

If your symptoms persist, we recommend visiting a urology clinic for further evaluation.

Thank you, and we hope this information was helpful.