What methods do doctors typically use in clinics to remove stones?

Hey, I saw your question and thought I'd share what I know – hope it helps!

How doctors deal with stones in a clinic setting depends entirely on the stone type, its size, and location. Since you mentioned tonsil stones and kidney stones, the approaches for those two are quite different.

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I. Tonsil Stones: Usually Simple, Handled Easily in the Clinic

Tonsil stones, essentially, are "little rocks" formed from trapped food debris and bacteria in the tonsil crypts. They're usually small but can cause bad breath or a feeling of having something stuck in the throat. Doctors handle these directly in the clinic:

• Irrigation: The doctor might use a curved irrigator or a professional "water flosser" to aim a stream of pressurized water at the crypts, flushing the stones out. It's a bit like getting your throat "cleaned," with little to no discomfort.
• Curette or Suction: For larger stones or those deeper in, the doctor may use a small tool called a "curette" (like a tiny spoon) to gently scoop or dislodge the stone. Sometimes suction is used to pull it out instead. This is quick; at most, they might use a local anesthetic spray on your throat, and it's over in minutes.

Summary: Treating tonsil stones is essentially about physical removal and can be easily handled at a clinic or outpatient office.

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II. Kidney Stones (or Ureter Stones): This Gets More Complex, and Depends on the Situation

Stones in the urinary system (kidney stones, ureter stones, bladder stones, etc.) aren't as simple as "just scooping them out." In a clinic setting, the focus is mainly on investigation and some non-invasive treatments. Major surgeries usually require a hospital.

1. Medication (Suitable for Small Stones)

This is the most common and least invasive approach. If your stone is small (e.g., less than 0.5 cm), smooth-surfaced, and well-positioned, the doctor will likely suggest you try to pass it naturally.

• How it works: The doctor prescribes medications, primarily two types:
  • Alpha-blockers: These relax and dilate the ureter (the tube connecting the kidney to the bladder), giving the stone a wider path to move through.
  • Diuretic medication, or just instructing you to drink more water: This increases urine volume, using the force of the flow to push the small stone down.
• Your role in the clinic: Visit the doctor, get an ultrasound or CT scan to confirm the stone's status, get the medication, and go home. The doctor will emphasize drinking plenty of fluids, staying active/moving, and scheduling follow-up appointments.

2. Extracorporeal Shock Wave Lithotripsy (ESWL)

This is the "star technology" for treating kidney stones and upper ureteric stones. Many urology clinics or hospital outpatient departments have this equipment.

• How it works: You lie on a special table. Doctors use X-rays or ultrasound to pinpoint the stone's location. Then, the machine projects high-energy shock waves from outside your body.
• An analogy: It's like "breaking stones through vibration." The shock waves pass through your skin and muscle tissue, focusing their energy precisely on the hard stone, shattering it into tiny sand-like fragments. These fragments then pass naturally in your urine.
• Feeling: You're awake during the procedure. General anesthesia is rarely needed, though you might feel something like a rubber band snapping lightly against your skin. You can usually go home the same day.

3. Ureteroscopic Lithotripsy (URS)

This approach is a bit more invasive but is now very routine. It's often done as day surgery (you go home the same day) in well-equipped clinics or hospitals.

• How it works: Think of it like an endoscopy, but the "scope" goes up your urethra. The doctor inserts a very thin, flexible ureteroscope through your urethra -> bladder -> ureter → guided right up to the stone.
• Finding the stone: Once located, instruments passed through the scope's working channel break the stone up. The most common tool is a laser – the doctor sees the stone through the scope and breaks it into dust. For smaller stones, a small wire basket "grasper" can simply grab and remove it.
• Feeling: You'll need anesthesia (local, regional, or sometimes general), so you won't feel it during the procedure. Afterwards, a soft stent (D-J stent, double J stent) may be temporarily placed in the ureter to prevent swelling and blockage.

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Summary

A final reminder: the specific method used must always be based on your doctor's professional judgment. They will choose the safest and most effective plan according to your stone's size, location, composition, and your overall health. Definitely don't try to handle this yourself!