Kidney Stones

A stone in your kidney is an irregularly-shaped solid mass or crystal that can be as small as a grain of sand up to the size of a golf ball. Depending on the size of your kidney stone (or stones), you may not even realize that you have one.

Causes of Kidney Stones #

The substances that combine into stones normally pass through your urinary system. When they don’t, it’s because there isn’t enough urine volume, causing the substances to become highly concentrated and to crystalize. This is typically a result of not drinking enough water.

The stone-forming substances are:

• Calcium.

• Oxalate.

• Uric acid.

• Phosphate.

• Cystine (rare).

• Xanthine (rare).

Symptoms of Kidney Stones #

• Feeling pain in your lower back or side of your body. This pain can start as a dull ache that may come and go. It can also become severe and result in a trip to the emergency room.

• Having nausea and/or vomiting with the pain.

• Seeing blood in your urine.

• Feeling pain when urinating.

• Being unable to urinate.

• Feeling the need to urinate more often.

• Fever or chills.

• Having urine that smells bad or looks cloudy.

Diagnosis of Kidney Stones #

Imaging tests #

An X-ray, CT scan and ultrasound will help your healthcare provider see the size, shape, location and number of your kidney stones. These tests help your provider decide what treatment you need.

Blood test #

A blood test will reveal how well your kidneys are functioning, check for infection and look for biochemical problems that may lead to kidney stones.

Urine test #

This test also looks for signs of infection and examines the levels of the substances that form kidney stones.

Treatment of Kidney Stones #

Medications #

Medications may be prescribed to:

• Decrease pain. Your healthcare provider may recommend that you take an over-the-counter medication like ibuprofen or, if you’re in the emergency room, an IV narcotic.

• Manage nausea/vomiting.

• Relax your ureter so that the stones pass. Commonly prescribed medicines include tamsulosin (Flomax) and nifedipine (Adamant or Procardia).

• You should ask your healthcare provider before you take ibuprofen.

• This drug can increase the risk of kidney failure if taken while you’re having an acute attack of kidney stones especially in those who have a history of kidney disease and associated illnesses such as diabetes, hypertension and obesity.

Surgery #

There are four types of surgeries used to treat kidney stones. The first three are minimally invasive, meaning that the surgeon enters your body through a natural opening (like your urethra), or makes a small incision.

Ureteroscopy #

To perform this procedure, a small instrument called an ureteroscope is inserted in your urethra, through your bladder and into a ureter. This instrument shows the kidney stones and then retrieves them in a surgical basket, or breaks them apart using a laser. These smaller pieces of the kidney stones are then easily able to exit your body through your urinary tract.

Shockwave lithotripsy #

In this procedure, you’re placed on a special type of surgical table or tub. High-energy shockwaves are sent through water to the stone(s). The shockwaves break apart the stones, which are then more easily able to exit your body.

Percutaneous nephrolithotomy #

• When kidney stones can’t be treated by the other procedures either because there are too many stones, the stones are too large or heavy or because of their location percutaneous nephrolithotomy is considered.

• In this procedure, a tube is inserted directly into your kidney through a small incision in your back.

• Stones are then disintegrated by an ultrasound probe and suctioned out so that you don’t have to pass any fragments.

• A urethral stent is placed after the procedure (an internal tube from the kidney to the bladder which is removed one week later).

• Patients are typically kept overnight for observation.

Open stone surgery #

A longer cut is used during this surgery. Compared to minimally invasive procedures, it’s rarely performed (0.3% to 0.7% of cases).