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What treatment options are available for a 9 mm kidney stone and a 4 cm cyst without symptoms?
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Kidney & Urinary Health
Question #30063
31 days ago
76

What treatment options are available for a 9 mm kidney stone and a 4 cm cyst without symptoms? - #30063

Client_ceb19f

My mother, Selina Akter Lipi, has a 9 mm stone in the upper part of her left kidney and a 4 cm cystic area. She has no pain, vomiting, or urinary symptoms. What treatment do you recommend? Is observation enough, or should she undergo ESWL or another procedure?

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Dr. Bharat Joshi
I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.
31 days ago
5

Hello dear See as per clinical history it seems chronic renal colic Fortunately there is no Pain Swelling Micturition problem Fever So it requires conservative treatment Iam suggesting some tests Please share the result with urologist in person for better clarity Cbc Esr Serum ferritin Serum tsh Serum hb Rft Lft Gfr Serum creatinine Serum bilirubin Hemogram Urine analysis Urine culture Kidney USG Ct scan kub Hopefully you recover soon Regards

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For a 9 mm kidney stone, there are a few treatment routes we can consider, depending on her symptoms, stone composition, and overall health. Given that she currently does not have pain or other symptoms, it’s reasonable to evaluate both active treatment and observation. Extracorporeal Shock Wave Lithotripsy (ESWL) is a non-invasive procedure often used for stones of this size. It uses sound waves to break the stone into smaller pieces that can be passed more easily through urination. This option is good for stones in the kidney and upper ureter, especially when stones are of a certain density and easy to target.

However, whether to proceed with ESWL also depends on factors like stone density and location. If the stone isn’t causing symptoms or complications like infection, and if her health allows, some experts might suggest a period of watchful waiting, where regular monitoring with imaging is done to check for changes in size or position. This would also include staying hydrated to potentially facilitate natural passing of stone pieces.

Regarding the 4 cm cystic area, kidney cysts that are simple (with clear fluid and no solid masses) generally do not necessitate intervention if they are asymptomatic. However, regular follow-ups with ultrasound or CT can ensure that it remains stable and that no complications arise.

Discussing further with a urologist can provide more personalized guidance as they can perform more detailed assessments, considering all aspects which might not be fully visible in current imaging. They might also evaluate factors like risk for potential obstruction based on her lifestyle, diet, and any other comorbid conditions she might have. In some instances, the combined approach, integrating both ESWL and observation, can be tailored to best suit her situation.

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