Conditions
Renal calculi can sit in the renal pelvis, calyces, or at the pelvi-ureteric junction. The imaging appearance on CT guides whether shockwave lithotripsy, flexible laser renoscopy, or percutaneous ultrasonic and laser lithotripsy is the better match.
Non-obstructing stones that cause no symptoms can sometimes be observed with surveillance imaging, in line with international guideline themes referenced on the Urology NSW kidney stone page. When treatment is chosen, ESWL remains a common option for stones under about 1 cm in favourable positions, while flexible ureteroscopy competes strongly in the 1 to 2 cm range.
Lower-pole anatomy makes flexible ureteroscopy technically harder. AUA (2026) expert opinion advises against first-line ESWL for lower-pole stones over 1 cm and for non-lower-pole renal stones over 2 cm. For lower-pole stones over 1 cm, AUA states PCNL achieves higher stone-free rates than ESWL or ureteroscopy (strong recommendation, Grade A). Staghorn and very large volumes are usually managed primarily with PCNL lithotripsy tools.
The rooms can arrange a consultation to review imaging and outline which form of lithotripsy, if any, fits your situation.