Kidney stones typically cause severe flank pain, but some develop silently, gradually damaging the kidneys without noticeable symptoms.
A man in his early 40s visited the clinic complaining solely of frequent urination. Diagnostic imaging revealed a large 3–4 cm stone in his right kidney that was obstructing the urinary tract, promoting the formation of additional stones and causing urine backup, which led to swelling (i.e., hydronephrosis).
Remarkably, the patient experienced minimal pain. Without timely intervention, the patient's kidney function could have deteriorated significantly within a few years. Many patients presenting without symptoms already have irreversible renal damage.
During surgery, the primary stone was completely fragmented using a laser. However, a smaller stone located deep within the kidney was difficult to reach through the initial access route. After discussion with the patient, surgeons used a flexible endoscope to create an additional route, successfully removing all stones.
The combined use of PCNL and retrograde intrarenal surgery (RIRS) with a flexible ureteroscope is becoming increasingly common in managing complex kidney stone cases. The procedure was successful, and the patient is recovering well.
This case underscores a critical point: kidney stones can grow silently, impairing renal function without symptoms. Larger stones, especially when asymptomatic, pose significant risks. Kidney function often declines gradually, and once impaired, is difficult to restore.
Even without symptoms, suspected kidney stones demand prompt diagnostic evaluation and treatment. The kidneys can fail quietly, and vigilance is essential.
Lim Hye Jung, HEALTH IN NEWS TEAM
press@hinews.co.kr
