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Urology • Andrology • ReSurgeClinic
Kidney Stones and Urinary Stone Disease
At ReSurgeClinic in Kyrenia / Cyprus, kidney stones, ureter stones and bladder stones are evaluated by Assoc. Prof. Necmi BAYRAKTAR according to stone location, size, effect on the kidney, infection risk and the patient’s general condition. In stone disease, emergencies are excluded first; in patients who do not benefit from medical treatment or require active intervention, minimally invasive options such as URS, RIRS, percutaneous stone surgery, supine percutaneous technique and combined stone treatment (ECIRS) are planned individually.
Emergency assessmentURS / RIRSPercutaneous stone surgerySupine PCNL / ECIRS
2000+PCNL operationsPercutaneous stone surgery experience
During the first consultation
The main complaint, duration of symptoms, previous treatments, accompanying diseases, medications, expectations and relevant examination findings are evaluated together.
Clinical focus
The aim is not to apply the same treatment to every patient, but to understand the underlying mechanism and choose the safest suitable step.
Treatment logic
Follow-up, medical treatment, minimally invasive procedures or surgery are discussed step by step according to the patient’s condition.
Detailed information
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How does stone disease present?
Kidney and ureter stones may cause flank pain, nausea, blood in urine, urinary symptoms or no symptoms at all.
The severity of pain alone does not always show the seriousness of the stone; obstruction and infection risk are critical.
Stone-related emergencies
Fever with obstruction, uncontrolled pain, a solitary kidney with obstruction or impaired kidney function requires urgent assessment.
A febrile obstructed kidney is not only a pain problem; it may become a serious infection risk requiring drainage.
How is diagnosis made?
Urine and blood tests, ultrasound and low-dose non-contrast CT are selected according to symptoms, pregnancy status and urgency.
Treatment is chosen according to the stone and the patient, not according to the name of the method alone.
Fever with an obstructing stone is an emergency
An infected obstructed kidney may require urgent drainage with a stent or nephrostomy before definitive stone treatment.
URS, RIRS, PCNL, supine PCNL or ECIRS are selected according to stone location, size, anatomy and infection status.
Not every stone is treated in the same way
Location, size, density, anatomy, infection, kidney function and patient preference determine the method.
Percutaneous stone surgery is powerful for large kidney stones. Supine percutaneous positioning and ECIRS may allow combined access in selected complex stones.
ESWL: shockwave treatment from outside the body
ESWL may be suitable for selected stones; success depends on stone and patient factors, and additional treatment may be needed.
URS: endoscopic treatment of ureter stones
A thin endoscope is passed through the urinary tract to fragment or remove a ureteral stone.
RIRS: flexible endoscopic treatment inside the kidney
Flexible ureteroscopy reaches selected kidney stones through the natural urinary tract without a skin incision.
Percutaneous stone surgery for large kidney stones
PCNL accesses the kidney through a small tract in the back or flank and is often preferred for large or complex stones.
Supine percutaneous surgery
In suitable patients, PCNL can be performed without turning the patient prone and may facilitate combined access.
Combined stone treatment (ECIRS)
ECIRS combines percutaneous and flexible endoscopic access in the same session for selected complex stones.
Preparation before surgery
Urine culture, kidney function, blood count, coagulation, medicines and imaging are reviewed before treatment.
Follow-up after treatment
Residual stones, stent removal, infection, symptoms and kidney drainage are checked according to the procedure.
Can stone recurrence be reduced?
Fluid intake, stone analysis, metabolic assessment and diet tailored to the stone type can reduce recurrence risk.
Our approach at ReSurgeClinic
The aim is to select the least invasive method likely to achieve safe stone clearance while protecting kidney function.
Treatments and procedures
Observation and medical support
Suitable small stones may be monitored or supported with symptom control and medical expulsive therapy.
ESWL
External shockwaves fragment selected stones without an incision.
URS
Endoscopic treatment for ureteral stones.
RIRS
Flexible endoscopic treatment for selected kidney stones.
Percutaneous stone surgery
A strong option for large or complex kidney stones.
Supine PCNL
Percutaneous surgery in the supine position for suitable patients.
Combined stone treatment (ECIRS)
Percutaneous and flexible endoscopic access in the same session.
Stone analysis and prevention
Stone composition, blood and urine tests guide an individualized recurrence-prevention plan.
Frequently asked questions
Which doctor treats kidney stones in Kyrenia?
Kidney and urinary stones are assessed and treated by a urologist.
Does every kidney stone need surgery?
No. Size, location, symptoms, obstruction, infection and kidney function determine the need for intervention.
Why is fever with a stone an emergency?
Infection behind an obstruction can progress rapidly and may require urgent drainage.
What is the difference between URS and RIRS?
URS commonly treats ureteral stones; RIRS uses a flexible scope to reach selected stones inside the kidney.
When is PCNL performed?
It is often considered for large, complex or hard kidney stones and when other methods are unlikely to clear the stone effectively.
What is an advantage of supine PCNL?
It avoids prone positioning and may make combined endoscopic access easier in selected patients.
What does ECIRS mean?
It is combined percutaneous and retrograde endoscopic stone surgery during the same session.
Is a JJ stent permanent?
Usually not. The removal or replacement date should be clearly planned and not missed.
How can recurrence be reduced?
Adequate fluids, stone analysis, metabolic evaluation and an individualized dietary plan can reduce risk.
