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/ Urinary Disorders / Urinary Stones / Kidney Stones

Definition

A kidney stone is a solid mass made up of tiny crystals. One or more stones can be in the kidney or ureter at the same time.

Kidney Stones Causes & Symptoms

Causes, Incidence, and Risk Factors

Kidney stones can form when the urine contains too much of certain substances. These substances can create small crystals that become stones. Kidney stones may not produce symptoms until they begin to move down the ureter, causing pain. The pain is usually severe and often starts in the flank region, then moves down to the groin.

Kidney stones are common. A person who has had kidney stones often gets them again in the future.

Some types of stones tend to run in families.

Types of stones include

  • Calcium stones are most common.
  • Cystine stones can form in people who have cystinuria.
  • Struvite stones are mainly found in women who have a urinary tract infection.
  • Uric acid stones are more common in men than in women.
  • Other substances also can form stones.

Symptoms

  • Abdominal pain
  • Abnormal urine color
  • Blood in the urine
  • Chills
  • Excess urination at night
  • Fever
  • Flank pain or back pain
    • Colicky (spasm-like)
    • May move lower in flank, pelvis, groin, genitals
    • On one or both sides
    • Progressive
    • Severe
  • Groin pain
  • Nausea, vomiting
  • Painful urination
  • Testicle pain
  • Urinary frequency/urgency
  • Urinary hesitancy

Treatment

The goal of treatment is to relieve symptoms and prevent further symptoms. Small Kidney stones usually pass on their own.

Drink at least 6 - 8 glasses of water per day to produce a large amount of urine. Some people might need to get fluids through a vein (intravenous).

Stones that don't pass on their own might need to be removed with surgery. Lithotripsy may be an alternative to surgery. It uses ultrasonic waves or shock waves to break up stones. Then the stones can either exit the body in the urine (extracorporeal shock-wave lithotripsy-ESWL) or be removed with an endoscope that is inserted into the kidney via a small opening (percutaneous nephrolithotomy-PCNL).

You may need to change your diet to prevent some types of stones from coming back.

Prevention

If you have a history of stones, drink plenty of fluids (6 - 8 glasses of water per day) to produce enough urine. Depending on the type of stone, you might need to take medications or other measures to prevent the stones from returning.

Extracorporeal Shock Wave Lithotripsy (ESWL)
Extracorporeal shock wave lithotripsy (ESWL) is the most frequently used procedure for the treatment of kidney stones. In ESWL, shock waves that are created outside the body travel through the skin and body tissues until they hit the denser stones. The stones break down into small particles and are easily passed through the urinary tract in the urine.

Kidney Stones Removal & Prevention

Percutaneous Nephrolithotomy (PCNL)
Sometimes a procedure called percutaneous nephrolithotomy is recommended to remove a stone. This treatment is often used when the stone is quite large or in a location that does not allow effective use of ESWL.

In this procedure, the surgeon makes a tiny incision in the back and creates a tunnel directly into the kidney. Using an instrument called a nephroscope, the surgeon locates and removes the stone. For large stones, some type of energy probe-ultrasonic or Laser-may be needed to break the stone into small pieces.

Percutaneous Nephrolithotomy

Laser for Kidney Stone

Advantages

  • Minimal invasiveness
  • Reduced p.o. pain & need for analgesia
  • Shorter period of recovery
  • Tubeless Surgery
  • Minimal Bleeding
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