How do doctors treat large or deeply embedded kidney stones?

Hey, noticed your question. It's a good one because the term "stones" covers a broad scope, and the treatment approaches can vary significantly. Based on your tags, I'll discuss kidney stones and tonsil stones separately; it'll be much clearer.

Part 1: Kidney Stones (and Stones in the Urinary System)

If a kidney stone is relatively large (typically meaning a diameter exceeding 1 cm) or stuck in a tricky location (like lodged in the ureter), simply drinking more water on your own usually won't work. Waiting it out unnecessarily could potentially lead to kidney damage (hydronephrosis) – time to see the urologist. Thankfully, the techniques are very mature these days, mostly minimally invasive, so there's no need to worry too much.

The urologist has several main "tools," and they will choose the best one based on your stone's size, hardness, and location:

1. Extracorporeal Shock Wave Lithotripsy (ESWL)

What it is: This is the most common non-invasive method. You lie on a machine; the doctor locates your stone using ultrasound or X-ray. A machine then fires special "shock waves" externally, targeting the stone's location.
In simple terms: Think of it like focusing energy that bypasses your skin and muscle to concentrate precisely on the stone, shattering it into sand-like particles. You then drink more water to flush these tiny fragments out with your urine.
Pros: No surgery, no tubes, you go home the same day.
Cons: Less effective for very large or extremely hard stones, or for stones in deep locations. Sometimes requires more than one session.

2. Ureteroscopy with Laser Lithotripsy (URS)

What it is: This is a minimally invasive surgical procedure. The doctor threads a very fine, flexible endoscope (called a ureteroscope) through your urethra, working its way "upstream" along the urinary tract to locate the stone lodged in the ureter or kidney.
In simple terms: Imagine the doctor sending a "miniature robot" with a camera through your body's natural passageway. Once the stone is found, the tip of the scope can deploy a laser fiber – like firing a "laser gun" – to blast the stone apart. A tiny basket is then used to retrieve the pieces.
Pros: High efficiency in breaking and clearing stones, often resolved in one go. It's very precise because the doctor works "under direct vision".
Cons: Requires anesthesia, qualifies as minor surgery, and usually requires a hospital stay for a few days.

3. Percutaneous Nephrolithotomy (PCNL)

What it is: This is the "ace in the hole" for treating large and complex kidney stones, such as staghorn calculi (which branch out like deer antlers, filling the renal pelvis).
In simple terms: This method is a bit more "hardcore." The doctor makes a small incision (about 1 cm) in your lower back to create a direct "tunnel" from the skin to the kidney. A tube called a nephroscope is inserted, providing an excellent view. Ultrasound or laser energy is then used to break the large stone into pieces, and a suction device removes the fragments simultaneously.
Pros: Most effective treatment for massive, complex stones, achieving very high stone clearance rates.
Cons: More invasive than ureteroscopy, with a longer hospital stay. However, compared to traditional open surgery, it's a world of difference.

Kidney Stone Summary: The urologist is like a combat engineer with various tools: For smaller, brittle stones, use "shock waves" for remote blasting; for stones lodged in the pipes, send in the "miniature robot" for precise intervention; for large, hard fortresses, create a small access hole and perform targeted clearance right at the source.

Part 2: Tonsil Stones

This is a completely different story from kidney stones, although both are called "stones." Tonsil stones are generally not dangerous but can cause bad breath (halitosis) and a feeling of something stuck in the throat, which can be very annoying.

If the stones are large or deeply embedded and you can't remove them yourself with cotton swabs, doctors (usually Ear, Nose, and Throat specialists - ENT) generally handle them like this:

In-office Removal: For ENTs, this is often a quick and easy procedure. They have specialized tools (like curettes or suction devices) and can usually dislodge or suck out the stone easily after spraying a local anesthetic in your throat. The process is quick and generally not very painful.
Tonsil Cryptolysis: If you have deep pits ("crypts") on your tonsils causing stones to recur, your doctor might recommend this.
- In simple terms: This uses lasers or plasma technology to cauterize (burn) and smooth out the troublesome pits where debris and bacteria hide. With fewer places to accumulate, stones are less likely to form. This is also an outpatient/minor procedure.
Tonsillectomy: If the above methods aren't effective, or if tonsil stones are severely impacting your quality of life, your doctor might suggest removing the tonsils.
- In simple terms: Consider this the definitive solution. Since the tonsils are the source of the problem, removing them entirely eliminates the possibility of new tonsil stones forming. It's the most permanent fix.

I hope this clarifies matters! In summary, regardless of the type of stone, if you discover a problem, see the appropriate specialist (urologist for kidney stones, ENT for tonsil stones). They will recommend the most suitable treatment plan for your specific situation.