Stone Removal Research Articles

Assessment of pancreatic ductal stone density on non-contrast computed tomography for predicting the outcome of extracorporeal shock wave lithotripsy.

Background and study aims The utility of stone density at non-contrast computed tomography (NCCT) for predicting the effectiveness of extracorporeal shock wave lithotripsy (ESWL) in chronic calcific pancreatitis (CCP) is relatively unexplored. Patients and methods This was a prospective observational study of patients with CCP. Hounsfield units (HU) were determined for the largest pancreatic ductal stone during pretreatment NCCT. All patients underwent ESWL until the largest stone was fragmented to <3mm, followed by endoscopic retrograde cholangiopancreatography (ERCP) for stone extraction. The predictive factors following ESWL for successful stone extraction were studied and the receiver operating characteristic (ROC) curve determined the HU optimal cut-point. Results Eighty-two patients with a median (interquartile range) age of 36 years (range, 29-55); majority male 45 (54.9%), were included. Idiopathic CCP was noted in 78 patients (95.1%). The median stone density (SD) was 1095 HU (range, 860.7-1260.7) and the number of ESWL sessions was 2 (range, 2-3). Complete stone removal at index ERCP was achieved in 55 patients (67.1%). Those with partial clearance (n=27) needed a repeat ERCP, which was successful in 26 (96.3%); one patient (3.7%) underwent surgery. There was a significant, positive correlation between number of ESWL sessions and SD (r=0.797; P <0.001). On bivariate analysis, SD and the number of ESWL sessions revealed a significant association with complete ductal clearance. The optimal cut-point for complete stone removal by the ROC curve was 1106.5 HU (Youden index 0.726), with a sensitivity of 93% and a specificity of 80%. Conclusions The SD is a significant predictor of ESWL success followed by ductal clearance at ERCP, and <1106.5 HU is a predictor of good candidates for ESWL therapy.

Sialolithiasis in children

Introduction: Sialolithiasis is a disease in which calcified substances accumulate in the ducts or parenchyma of the salivary glands. This disease can occur in people of all ages but is mostly seen in middle-aged adults and rarely in children. This case report aimed to describe a case of sialolithiasis in children Case Report: A 3-year-old girl presented with a lump that enlarged progressively on the right side of the neck since 1 year ago. The patient also complained of painful swallowing. Palpation of the right submandibular revealed a solid, mobile mass measuring 0.5x0.5cm without tenderness or hyperemia. A neck ultrasound showed an enlarged submandibular gland and right parotid gland. A midface and neck multi-slice computed tomography scan (MSCT) supported the diagnosis of sialolithiasis. The patient underwent stone removal with an extraoral approach and general anesthesia. The patient then was discharged with cefixime, methylprednisolone, and paracetamol. Discussion: Sialolithiasis that cannot be removed by opening the canal can be removed by trans-oral or extra-oral sialolithotomy, extracorporeal lithotripsy, sialendoscopy, or laser treatment. Submandibular stones can be removed surgically by intraoral or extraoral approaches. Extraoral approaches are indicated for intra-glandular stones and stones embedded in the hilum of the gland. Conclusion: The diagnosis of sialolithiasis in this patient was confirmed through history taking, physical examination, ultrasound, and a CT scan. Management of sialolithiasis focuses on removing the stone and maintaining salivary gland function. In this case, the stone was removed using an extraoral approach under general anesthesia which resulted in a good outcome

Considering kidney stones and the bidirectional relationship between nephrolithiasis and urinary Tract Infection (UTIs): a systematic review of the literature on cause and effect

Urinary tract infections (UTIs) and kidney stones also known as nephrolithiasis, it have complicated and reciprocal interaction that makes both conditions worse. We conducted an extensive study to ascertain the connection between “kidney stone disease (KSD)” and recurrent “Urinary Tract Infection (UTIs)”, as well as to evaluate the impact of kidney stone treatment on UTI resolution. We found that there is a strong correlation between KSD and UTI in several studies after evaluating 15 publications. Though the technique resolves UTIs, there is conflicting information about the likelihood of recurrence following kidney stone removal surgery. Our understanding of the potential role of bacteria in the genesis of "metabolic" stones can improve with the aid of vitro research. Our study shows that KSD and UTIs coexist and have an influence on one another. Consequently, individuals with a history of urinary tract infections (UTIs) or other risk factors can be advised to pursue prophylactic measures such kidney stone removal, regardless of the kind of stone. A stone culture test should be conducted to determine the specific bacteria causing the UTI to reduce the likelihood of recurring episodes and to enable more precise and effective antibiotic treatment strategy.

Risk factors for recurrence of common bile duct stones after surgical treatment and effect of ursodeoxycholic acid intervention.

Endoscopic retrograde cholangiopancreatography (ERCP) is an accurate diagnostic method for choledocholithiasis and treatment option for stone removal. Additionally, ursodeoxycholic acid (UDCA) can dissolve cholesterol stones and prevent their development and reappearance by lowering the cholesterol concentration in bile. Despite these treatment options, there are still patients who experience stone recurrence. To analyze the risk factors for choledocholithiasis recurrence after ERCP retrograde cholangiopancreatography and the effect of UDCA intervention. The clinical data of 100 patients with choledochal stones who were hospitalized at the Yixing People's Hospital and underwent ERCP for successful stone extraction between June 2020 and December 2022 were retrospectively collected. According to the post-ERCP treatment plan, 100 patients were classified into UDCA (n = 47) and control (n = 53) groups. We aimed to assess the clinical efficacy and rate of relapse in the two patient populations. We then collected information (basic demographic data, clinical characteristics, and serum biochemical indicators) and determined the factors contributing to relapse using logistic regression analysis. Our secondary goal was to determine the effects of UDCA on liver function after ERCP. Compared to the control group, the UDCA group demonstrated a higher clinical effectiveness rate of 92.45% vs 78.72% (P < 0.05). No significant differences were observed in liver function indices, including total bilirubin, direct bilirubin, gamma-glutamyl transpeptidase, alanine aminotransferase, alkaline phosphatase, and aspartate aminotransferase, between the two groups before treatment. After treatment, all liver function indices were significantly reduced. Comparing the control vs UDCA groups, the UDCA group exhibited significantly lower levels of all indices (55.39 ± 6.53 vs 77.31 ± 8.52, 32.10 ± 4.62 vs 45.39 ± 5.69, 142.32 ± 14.21 vs 189.63 ± 16.87, 112.52 ± 14.25 vs 149.36 ± 15.36, 122.61 ± 16.00 vs 171.33 ± 22.09, 96.98 ± 10.44 vs 121.35 ± 11.57, respectively, all P < 0.05). The stone recurrence rate was lower in the UDCA group (13.21%) in contrast with the control group (44.68%). Periampullary diverticula (OR: 6.00, 95%CI: 1.69-21.30), maximum stone diameter (OR: 1.69, 95%CI: 1.01-2.85), stone quantity >3 (OR: 4.23, 95%CI: 1.17-15.26), and positive bile culture (OR: 7.61, 95%CI: 2.07-27.91) were independent factors that influenced the relapse of common bile duct stones after ERCP (P < 0.05). Furthermore, postoperative UDCA was identified as a preventive factor (OR: 0.07; 95%CI: 0.08-0.09). The intervention effect of UDCA after ERCP for common bile duct stones is adequate, providing new research directions and references for the prevention and treatment of stone recurrence.

Retracted: Effects of Stone Removal via Different Approaches in the Treatment of Incarcerated Upper Ureteral Calculi: A Comparative Study.

[This retracts the article DOI: 10.1155/2022/7651215.].

Outcome of forgotten biliary stents for more than fiveyears-A two-decade experience.

Prolonged biliary stenting may lead to complications such as cholangitis, stentolith and stent migration. There is limited data on forgotten biliary stents for more than fiveyears in literature. The aim of this retrospective study was to analyze the complications and outcomes in patients who forgot to get their biliary stents removed or exchanged for more than fiveyears. The study population included patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) and plastic biliary stent placements in a tertiary care center from 1990 to 2022 for benign biliary diseases. Loss to follow-up and subsequent forgotten stent for more than fiveyears were observed in 40 patients who underwent ERCP during this study period. We retrospectively analyzed the indications of stenting, present status of stent, complications and outcomes in the study patients. The mean age of the study patients was 51.5 ± 11.5years with 27 females. Indications of biliary stent placement were choledocholithiasis (33, 82.5%), bile leak (3, 7.5%), benign biliary stricture (2, 5%) and choledochal cyst (2, 5%). The mean duration of forgotten stent was 5.9 ± 3.6years. Presenting symptoms were abdominal pain (37, 92.5%), fever (26, 65%) and jaundice (32, 80%). Most commonly placed stent was 7 French double pigtail of 10cm length. Complications in the study patients were cholangitis (35, 87.5%), internal migration (2, 5%), pancreatitis (1, 2.5%) and portal hypertension (1, 2.5%). The outcomes were stone removal (30, 90.9%), stent removal (31, 77.5%), stent reinsertion (19, 47.5%), broken stent (3, 7.5%) and surgery (2, 5%). Prolonged duration (> 5years) of forgotten stent is uncommon and is observed most commonly in patients with choledocholithiasis. The most common complication of long duration of forgotten stents was cholangitis followed by internal migration, pancreatitis and portal hypertension. Stone and stent removal was successful in amajority of patents, while surgery was required in less number of patients.

Numerical analysis of an obstacle motion in the human ureter using the dynamic mesh approach.

Peristalsis is a common motion in various biological systems, especially the upper urinary tract, where it plays a pivotal role in conveying urine from the kidneys to the bladder. Using computational fluid dynamics, this study aims to investigate the effect of various peristaltic parameters on the motion of an obstacle through a two-dimensional ureter. Methodologically, Incompressible Navier-Stokes equations were utilized as the fluid domain's governing equations, and the Dynamic Mesh method (DM) was employed to simulate the peristaltic and obstacle motion. The peristaltic motion was modeled by a sinusoidal contraction wave propagating alongside the ureter at the physiological speed, and the motion of the obstruction through the ureter, which is caused by the fluid forces applied on its surface, was explored using the equation of Newton's second law. Various test cases of different shapes and sizes were supposed as kidney stones to understand the influence of the peristalsis properties on the stone removal process. The results show that the motion of the kidney stone is highly influenced by the gradient pressure force applied to its surface in the fluid domain. Moreover, investigating the effects of the peristaltic physical properties on the obstacle's motion indicates that the stone's motion is dependent on these parameters. Furthermore, this analysis provides insight into the peristaltic motion effects, assisting physicians in developing new medicines to facilitate the kidney stone removal process based on its shape and size.

Optimal dilation duration of 10 mm diameter balloons after limited endoscopic sphincterotomy for common bile duct stones: a randomized controlled trial

Limited endoscopic sphincterotomy (EST) combined with endoscopic papillary balloon dilation (EPBD) is widely used. However, the optimal duration of small balloon dilation in choledocholithiasis remains controversial. We aimed to determine the optimal duration for 10 mm diameter balloon dilation after limited EST in choledocholithiasis. In this randomized controlled clinical trial, 320 patients were randomly assigned to receive small balloon dilation (10 mm in diameter) for 1 min (n = 160) or 3 min (n = 160) after deep bile duct cannulation. No significant difference in success rate of stone extraction between the two groups was observed. The incidence of post-ERCP pancreatitis (PEP) was higher in the 1 min group (10.6%) than in the 3 min group (4.4%) (P = 0.034). The logistic regression analysis showed that guidewire into the pancreatic duct, cannulation time > 5 min and 1 min balloon dilation were independent risk factors for PEP. There were no significant differences in other post-ERCP adverse events such as acute cholangitis, bleeding, perforation, etc. between the two groups. In conclusion, 3 min in duration was determined to be the optimal dilation condition for the removal of common bile duct stones.

Risk factors of stone residual after retrograde intrarenal surgery: A prospective cohort study.

Complete removal of renal stones is crucial for optimal patient outcomes, but recent studies have reported residual stones after retrograde intrarenal surgery (RIRS). This study aimed to identify the associated risk factors to improve patient management and treatment selection. This cohort study was conducted over 18 months at two hospitals and recruited adult patients with renal stones less than 3 cm. Preoperative assessment included medical history, physical examination, laboratory tests, and radiological imaging. Intraoperative and postoperative data collection and follow-up were conducted to evaluate surgical success and potential complications. A total of 100 patients were included, with a mean age of 45.3 ± 10.7 years and a mean BMI of 26.2 ± 1.4 kg/m2. Approximately 19% of the patients had residual stones after the RIRS procedure. The RUSS score showed good diagnostic performance with an AUC of 0.843, and the optimal cut point was ⩾2.0 with a sensitivity of 52.6% and specificity of 95.1%. Independent predictors of residual stones were multiple sites (OR = 24.98; p = 0.002), multiple stones (OR = 13.62, p = 0.002), stone size of 21-30 mm (OR = 4.91, p = 0.038), lower calyx site (OR = 4.85, p = 0.033), and surgeon experience of fewer than 50 cases (OR = 6.82, p = 0.020). This study identifies several factors associated with residual stones after RIRS for renal stones, including stone size, location, number, and surgeon experience. The study suggests that the RUSS score can be used as a reliable tool for predicting the likelihood of residual stones, which can help clinicians in patient selection and treatment planning.

Comparing triple scope-combined bile duct exploration lithotripsy with laparoscopic hepatectomy for hepatolithiasis (with video)

BackgroundTo compare the efficacy of Three-scope combined (laparoscopic, rigid choledochoscopy and electronic choledochoscopy, TS) with laparoscopic hepatectomy (LH) for patients with hepatolithiasis (HL). MethodsBetween January 2019 and January 2020, 118 consecutive patients with HL treated with TS (TS group, n = 57) or LH (LH group, n = 61) were analyzed in this study. Perioperative and long-term outcomes, including operative time, intraoperative blood loss, blood transfusion, postoperative bowel function recovery time, postoperative hospital stay, complication rate, stone removal rate, and stone recurrence rate, were compared and analyzed between the two groups. ResultsCompared with the LH group, the TS group had significantly lower intraoperative blood loss and transfusions, significantly shorter operative time and hospital stay, and fewer complications (P < 0.05 for all). There was no significant difference in the final stone removal rate, stone recurrence rate and postoperative bowel function recovery time (P > 0.05 for all). ConclusionTS is a safe and effective treatment for HL and is superior to LH in terms of overall treatment outcome and complications.

Bicentric retrospective study comparing the postoperative outcomes of patients treated surgically for bladder stones with or without concomitant surgery for BPH.

To compare the postoperative outcomes of male patients who underwent bladder stone (BS) removal, with or without concomitant benign prostatic hyperplasia (BPH) surgery. All men aged > 50years who underwent BS removal at two French university hospitals between 2009 and 2018 were retrospectively reviewed. Four binary outcome criteria were identified during the follow-up: early postoperative complications, stone recurrence, subsequent surgery for BS or BPH, and late surgical complications. A composite score ranging from 0 to 4 was calculated by combining the four criteria. A median follow-up period of 42months was observed in 179 patients. Of these, 107 patients were in the "concomitant surgical treatment" (CST) group and 72 in the bladder "stone removal alone" (SRA) group. The CST group presented higher baseline post-void residual volume (105 vs. 30ml, p = 0.005). Patients who underwent CST had a significantly lower rate of BS recurrence (12% vs. 39%; p = 0,001) and underwent fewer subsequent surgeries (14% vs. 44%; p < 0.001). There was no significant difference in the early (51% vs. 35%, p = 0,168) and late (26% vs. 17%, p = 0,229) complications rates between the two groups. A better composite score was observed in the CST than in the SRA, but the difference was not significant (3.07 vs. 2.72, p = 0.078). As CST increases morbidity and decreases the risk of reoperation, each situation should be considered, taking into account patient choice and comorbidities.

Clinical outcomes of holmium laser enucleation of the prostate: A large prospective registry-based patient cohort study under regular follow-up protocol.

To evaluate the efficacy and safety of holmium laser enucleation of the prostate (HoLEP) in a large prospective cohort of patients with benign prostatic hyperplasia (BPH) through systematic follow-up at a single institution. Clinical outcomes were analyzed between August 2008 and June 2022. Patients were followed-up at 2 weeks, 3 months and 6 months postoperatively. A total of 3,000 patients (mean age, 69.6±7.7 years) underwent HoLEP. Baseline total International Prostate Symptom Score (IPSS) was 19.3±7.7 and maximum flow rate (Qmax) was 9.4±4.8 mL/s. Mean total prostate volume was 67.7±3.4 mL. Total operation time was 60.7±31.5 minutes, and catheterization time was 1.0 days (range, 1.0-1.0 days). At 6 months postoperatively, the total IPSS decreased to 6.6±5.8 and Qmax increased to 22.2±11.3 mL/s. Complications at 6 months postoperatively included stress urinary incontinence (SUI) in 36 patients (1.9%), urgency urinary incontinence (UUI) in 25 (1.3%), bladder neck contracture (BNC) requiring transurethral incision (TUI) in 16 (0.5%), and urethral stricture in 29 (1.0%). Eleven patients (0.4%) with prostatic fossa stones required stone removal. Sixty-one patients (2.0%) required secondary surgery (transurethral coagulation, 16 [0.5%]; TUI for BNC, 16 [0.5%]; stone removal for prostatic fossa stones, 11 [0.4%]; and endoscopic internal urethrotomy for urethral stricture, 18 [0.6%]). Mid-term follow-up results after HoLEP in BPH patients showed excellent efficacy and low complication rates. Unlike previous reports, the incidence of SUI and UUI after HoLEP was low, but the occurrence of de novo stone formation in prostatic fossa was notable.

The use of ERCP/spyglass and associated accessories to get tissue diagnosis and achieve therapeutic treatment by direct viewing and removal of CBD stone, which was not seen in previous MRCP

The use of ERCP/spyglass and associated accessories to get tissue diagnosis and achieve therapeutic treatment by direct viewing and removal of CBD stone, which was not seen in previous MRCP

A multidisciplinary approach: removal of large common bile duct stones in a patient with Roux-en-Y gastric bypass not amenable to EDGE procedure and high surgical risk

A multidisciplinary approach: removal of large common bile duct stones in a patient with Roux-en-Y gastric bypass not amenable to EDGE procedure and high surgical risk

ERCP for common bile duct stones in the elderly: refining the procedure to improve outcomes.

Removal of common bile duct stones in patients with a previous cholecystectomy was one of the first indications for ERCP with biliary sphincterotomy. Thanks to a minimally invasive procedure, patients were prevented from having a new operation. Subsequently, as the technique proved to be successful, ERCP was extended to all patients with choledocholithiasis, regardless of whether or not they had gallbladder. Also contributing was the fact that, at least in the beginnings, surgical interventions on the bile duct with laparoscopic cholecystectomy were more difficult. Nowadays, many surgeons prefer to perform cholecystectomy with a bile duct clean of stones. In this issue of the Spanish Journal of Gastroenterology, Gardenyes et al. present a study on ERCP for common bile duct stones in elderly patients. The novelty of this study is not only to analyze the ERCP procedure, which we already knew has similar success and complication rates to younger patients, but also to focus on the long-term outcome, considering the frailty that frequently accompanies aging. The study concludes that older patients may benefit from enhanced care protocols to reduce medical adverse events and improve outcomes. For us gastroenterologists and endoscopists, another conclusion that can be drawn from this study is that we should not be satisfied that ERCP in older patients has the same success and complication rates as in younger patients, but rather we should strive to ensure that the results are even better.

Is the presence of upper tract transitional cell carcinoma in a calyceal diverticulum a risk factor for early metastasis? A case report and review of the literature

Upper tract transitional cell carcinoma poses diagnostic challenges due to its prevalence and diverse clinical presentations. This case report describes the incidental discovery of high-grade transitional cell carcinoma during the management of a 48-year-old male with ischemic heart disease and an asymptomatic right renal stone. During flexible ureteroscopy for stone removal, papillary lesions were identified within a calyceal diverticulum and confirmed as high-grade transitional cell carcinoma. The unique anatomy of the calyceal diverticulum, characterized by its restricted wall thickness, may predispose the tumor to early metastasis. Additionally, there is a concern about potential iatrogenic dissemination of tumor cells to the bladder during the ureteroscopic procedure. This case highlights the diagnostic complexities associated with upper tract transitional cell carcinoma in rare anatomical locations and emphasizes the need for careful consideration of both procedural factors and anatomical features to manage the risk of metastasis and tumor dissemination effectively.

A Scarce Case of Sarcomatoid Bladder Carcinoma and Bladder Stone in a 58-Year-Old Man: A Case Report

BACKGROUND: Sarcomatoid bladder carcinoma is scarcely found, with most cases of bladder carcinoma due to bladder stone as a risk factor consisting of squamous cell carcinoma. Only 221 cases were reported between 1973 and 2004 of sarcomatoid bladder cancer. Therefore, this case report brings out sarcomatoid bladder carcinoma and its clinical relevance. CASE DESCRIPTION: A 58 years old Indonesian man experienced gross hematuria for 3 months, and thus finally brought to the Emergency Room (ER) where he was initiated urinary catheter and given intravenous (IV) fluid along with analgesic parenterally. Emergency abdominal radiograph assessment and blood test were made. Abdominal radiograph assessment suggests a 6 x 6 cm opacity in the bladder and several urolithiasis in the pelvic cavity. Ureum and creatinine increased in the blood test procedure. Based on the characteristic appearance and radiological findings, a diagnosis of vesicolithiasis was made. Following the diagnosis, the patient was urgently operated on (Open vesicolithotomy), and during the stone removal, there was a tangled polyp-like mass found buried underneath the stone. Histological findings of mass and surrounding lymph nodes were made and histopathologically stated the mass was sarcomatoid carcinoma of the bladder and it had metastated to lymph node and pelvic region. CONCLUSION: Considering hematuria in urolithiasis is frequent, the clinician should be aware of any tumor findings especially when the hematuria is massive thus emergency urolithotomy should be considered immediately.

Comparison of stone clearance rate based on upper, middle, or lower calyx puncture in Mini Percutaneous Nephrolithotomy (mPCNL)

Introduction: PCNL is the most common surgical technique used for the management of renal stones, particularly for those with more than 2 cm stones. The aim of this study is to identify which kidney calyx—upper, middle, or lower—when punctured achieves the highest stone clearance rate. Methods: This was a prospective non-randomised study performed in department of urology, KIST medical college from September 1, 2021 to November 16, 2022. Patients who underwent PCNL were evaluated with detailed history, examination, and investigation. All the patients who fulfill the inclusion criteria during study period were included in the study. After preoperative investigation PCNL was done according to standard protocol. Perioperative complication recorded in Performa. Stone-free status was checked after 2 months of surgery with ultrasonography. Results: 100 patients were included in this study among which 59 were male. The mean age of patients was 33.35 years [range 18-65 years]. Upper, middle and lower pole puncture was done in 23%, 33% and 44% patients respectively. The mean stone burden of the patient was 380.680 mm2. The average time for surgery according to access was 67.34 mins, 63.12mins, and 64.07 mins for the upper calyx, mid-calyx and for the lower calyx respectively. 84.33% of patients had complete stone clearance after 2 months in the USG examination. 91.3% [21] had stone clearance when approached through the upper calyx. It was 87.8%[29] by mid calyx and 75%[33] by lower calyx. Upper calyx puncture had statistical significance in stone clearance rate [P=0.43, P=0.021, P=0.002]. 11 had CRIF ≤4mm stone in PCS, and the remaining 6 had residual stone &gt;4mm. In our study, thoracic complications were significantly higher in upper calyx puncture 8[30.4%, 8[24.24% in the middle calyx, and 3[6.8%] in lower calyx [P=0.02, P=0.98, P=0.03] respectively. Conclusion: Upper calyceal puncture can produce the highest stone clearance rate, but it has been associated with significant postoperative morbidity, particularly in the chest. Lower calyx punctures have less intraoperative and postoperative morbidity, but their stone removal rates are lower than those of other procedures. Therefore, the balance between stone clearance rate and morbidity has been achieved using middle calyx puncture.

A Large Anterior Urethral Calculus Presenting as Urethrocutaneous Fistula

Presentation of urinary calculus ranges from painful urination to acute retention. Diagnosed by x-ray pelvis and non-contrast CT and removal of stone by various methods is the management. Variety in symptoms, sometimes make clinical diagnosis difficult until radiological investigations confirm it. In this case presentation, initial diagnosis was made of Urethrocutaneous fistula may be due to distal stricture, but on investigating, he was diagnosed as urethral calculus in urethral diverticulum , as the reason for his symptoms

Detection of Kidney Stone and Estimation of its Size using Image Segmentation Techniques

The study discusses the development of a reliable strategy for detecting and segmenting kidney stones from CT scans. Kidney stones are solid materials that can form in the kidneys due to excessive amounts of specific minerals in the urine. Severe back, side, lower abdominal, or groin discomfort, or blood in urine can indicate kidney stone presence. The current method for detection using CT scans is widely used, but it requires more precise and efficient technology due to the laborious and time-consuming manual process. The objective of this report is to propose a robust approach for kidney stone detection and segmentation, employing threshold segmentation and the watershed algorithm along with pre-and post-image processing for noise reduction. Additionally, the method estimates the size of the stone, aiding in selecting the appropriate medical procedure for stone removal. The entire process is implemented on a dataset comprising numerous kidney stone images to test and validate its accuracy and reproducibility. The system's image quality enhancement is evaluated by calculating several parameters such as SSIM, PSNR, FSIM, NCC, and NAE on the output images. To further validate the suggested method, a comparison is made with two other existing algorithms based on the mentioned evaluation criteria. The proposed strategy promises to improve the accuracy and reliability of kidney stone detection and segmentation, providing a more efficient and effective solution for medical diagnosis and treatment