How big kidney stones need to be lithotripsy

  The treatment of kidney stones requires different treatment methods depending on the size of the stones. For stones below 6mm, oral stone removal medication can be chosen for stone removal, while stones above 6mm need to be removed directly or after lithotripsy. The size and location of the stone should be taken into consideration for what option to be used for stone removal after lithotripsy.  Extracorporeal shock wave lithotripsy can be performed for all kidney stones up to 2 cm in diameter. The stones are excreted in the urine after extracorporeal shock wave lithotripsy. However, stones that are too large may not be suitable for extracorporeal shock wave lithotripsy. This is because the number of lithotripsy treatments may increase and the large amount of lithotripsy can lead to kidney function damage. If the stones are too small, extracorporeal shock wave lithotripsy can also easily lead to kidney damage. Therefore, the indication size for extracorporeal shock wave lithotripsy treatment is stones less than 2 cm.  For stones larger than 2 cm, ureteroscopic lithotripsy or percutaneous nephrolithotripsy is recommended. Percutaneous nephrolithotomy is performed to remove or fragment the stone directly under the nephroscope after establishing a percutaneous channel.  For stones <2 cm, which are difficult to be lithotripsed by X-ray or extracorporeal shock wave, ureteroscopic lithotripsy can be chosen. The stone is removed after retrograde access to the pelvis and calyces via the ureter and lithotripsy.  The decision to lithotripsy is also not based solely on the size of the stone in the kidney, but also on whether it causes hydronephrosis and causes kidney infection. If the stone is combined with hydronephrosis, hydronephrosis in the renal calyces, or if the patient has symptoms of back pain, aggressive extracorporeal lithotripsy or surgical intervention is required.