最終更新日： 2026年5月18日
Another simplicity consulting in my office which is came from the health checkup program, it was a kidney stone finding coincidently. The most common imaging modality offered in health checkups is ultrasonography – easy to perform, affordable, and radiation-free. But when goes deeper at the performance, ultrasonography is just a screening tool.
Limitations of ultrasonography in kidney stone detection.
- Operator-dependent – Accuracy depends heavily on the radiologist’s experience and skill.
- High false positive rate – Ultrasound detects small kidney stones with only about 45% accuracy, and it can be difficult to distinguish true stones from calcified vessels or calcification in renal tissue.
- Difficult in obese patients – Thick adipose tissue interferes with the sound wave algorithm, reducing image quality significantly.
When a patient comes to see me, I evaluate whether a definitive investigation is needed. The gold standard is CT scan, which reaches 95% accuracy and can detect stones as small as 1.25 mm. Modern CT protocols use extremely low radiation doses – far below any hazardous level.
Do we need to remove every single kidney stone? The answer is “not every stone needs treatment.” The narrowest part of the urinary system is the ureter, which can allow stones sized at 4 mm or smaller to pass on their own without significant pain. If the stone is smaller than 4 mm, watchful observation is appropriate – no costly procedure is needed upfront.
私のおすすめ is to drink more than 2.5 liters of still water per day. Adequate hydration produces enough urine output to flush small stones out naturally. That said, even stones smaller than 4 mm can occasionally cause pain, so it is always best to consult your trusted urologist rather than waiting for symptoms to develop.
If a kidney stone has been found in your health checkup and you would like a proper urological evaluation, Dr. Soarawee Weerasopone offers specialist consultations at Bangkok Hospital Headquarters. 診療をご予約.
Frequently Asked Questions about Kidney Stone Treatment
No. Small kidney stones, particularly those 4 mm or smaller, have a good chance of passing on their own through the urinary tract without requiring intervention. Watchful waiting with increased fluid intake is the standard approach for small asymptomatic stones. Treatment is considered when stones are large, cause significant pain, block urine flow, or are associated with infection.
Ultrasound is a useful screening tool but has limitations for kidney stone detection. Its accuracy for detecting small stones is only around 45%, and it can produce false positive results by misidentifying calcified blood vessels or parenchymal calcifications as stones. A CT scan without contrast is the gold standard investigation, offering up to 95% accuracy and the ability to detect stones as small as 1.25 mm.
No. Modern CT protocols for kidney stone evaluation use an ultra-low radiation dose – far below any harmful level. The radiation exposure is minimal and considered safe for most patients. The diagnostic benefit of accurately identifying and sizing a stone far outweighs the negligible radiation risk, especially when compared to the consequences of missing or mismanaging a kidney stone.
Yes, stones 4 mm or smaller have a reasonable chance of passing naturally with adequate hydration. Drinking more than 2.5 liters of still water per day increases urine output, which helps flush stones through the urinary tract. However, even small stones can occasionally cause obstruction or pain, so urological monitoring is advisable during the observation period.
Kidney stone treatment is recommended when the stone is larger than 4–6 mm and unlikely to pass spontaneously, causes significant or persistent pain (renal colic), is associated with urinary tract infection or fever, causes urinary obstruction, or when the patient has a solitary kidney. Treatment options include shockwave lithotripsy, ureteroscopy, and percutaneous nephrolithotomy depending on stone size and location.
**免責事項:** このコンテンツは、バンコク病院本部の認定泌尿器科医であるSoarawee Weerasopone博士によって作成およびレビューされました。教育目的のみのものであり、医学的アドバイスを構成するものではありません。いかなる医療処置を開始する前にも、必ず資格のある医療専門家にご相談ください。.
医学的に記述・監修： ソアラウィー・ウィーラソポーン医師（ポム医師） — バンコク病院本社 泌尿器科専門医。 国際フェロー：ベイラー医科大学（米国）、順天堂大学（日本）、長庚紀念医院（台湾）。.
ソアラウィー・ウィーラソポーン医師（ポム医師）は、バンコク病院本院の泌尿器科専門医で、男性医学、ロボット手術（ダヴィンチシステム）、腎結石治療を専門としています。ベイラー医科大学（米国）、順天堂大学医学部附属順天堂医院（日本）、長庚記念医院（台湾）での国際フェローシップを修了しています。このサイトのすべての医療コンテンツは、ソアラウィー医師の臨床経験と国際的なトレーニングに基づいて、同医師によって作成・監修されています。.
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尿失禁（アクティブ膀胱）に問題がありました。私の人生は混乱していました。私は3週間寝ることができませんでした。横になると毎晩うんざりします。私は衝動に駆られますが、すぐにトイレに行きます…小さな川と何もありません。これは1晩に8〜10回で、これは私の全体的な健康と幸福に影響し、私の生活の質は丘を下っていきました。 Google検索でDrSoarawee Weerasoponeを見つけました。彼が辛抱強く私の問題に耳を傾け、答えを与える医者と話しなさい。彼は私にテストに来るように頼みます。 3週間後、私のシステムや病気は消えました。
ソアラウィ博士を強くお勧めします…尿失禁の対処に問題がある場合は、彼は座って実際にあなたの言うことに耳を傾けるでしょう、そして彼は素晴らしい素晴らしい性格を持っています。
どうもありがとう、私の友達