What are Kidney Stones?
Anyone who has ever had a kidney stone probably knows the pain that often accompanies them. These small, yet hard crystal-like deposits form over time in the kidney. Kidney stones are made up of tiny crystals of various compounds, mostly calcium, in the urine. If they remain small enough they will pass easily out of the urinary system. If the stone stays in the kidney and more crystals join it, forming a large stone, it may get stuck in the ureters (tubes from kidneys to bladder). This can be extremely painful.
What Causes Kidney Stones?
- Excess calcium in the urine (hypercalciuria)
- Hyperparathyroidism
- Immobilization
- Renal tubular acidosis – causes an acid and alkaline imbalance
- Caucasians have the highest incidence of kidney stones
- Stress
- Gout
- Inflammatory Bowel Syndrome
- Urinary Tract Infections
Symptoms
- Pain beginning abruptly on one flank may move to the groin area
- No position will help the pain subside
- Nausea and vomiting may occur
- Blood in urine
- Fever
- Urgency and frequency as the stone passes to the lower urinary tract
Treating Kidney Stones
Once imaging studies have proven the existence of kidney stones, treatment can begin:
- Observation of asymptomatic non-obstructing renal stones. For kidney stones that are small and not obstructing the urethra, you can watch for symptoms.
- Medical Expulsive Therapy: You will be given hydration to produce two liters of urine output over 24hrs and then medications to relax the urinary tract to allow the stone to pass through the urinary system. Once you pass the stone, your doctor will strain the urine to collect the stone and analyze it. You will be prescribed ongoing imaging (ultrasound) for several week after you pass the stone to ensure no other stones remain in the kidney.
Non-Surgical and Surgical Intervention, which includes:
- Extracorporeal Shock Wave Lithotripsy (ESWL) – Shock waves are used to break up the kidney stone into small stone fragments that can be passed through the urine.
- Ureteroscopy and Laser Lithotripsy – A small telescope is passed through the urethra and into the bladder and upper urinary tract with a holmium laser that fragments the stone so it can be passed through the urinary system.
- Percutaneous Nephrolithotomy (PCNL) – In this innovative surgical procedure for large kidney stones that cannot pass through the urinary tract, a small incision is made in the patient’s back to create a tract through the skin to the kidney to treat and remove large stones in the upper urinary tract.
