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1. What are Kidney Stones?
Kidney stones are abnormal collections of mineral salts which form in the kidney and then can move down the ureter (tube connecting the kidneys and the bladder) and into the bladder. The movement of the stone can cause the following symptoms:
- Severe pain in the mid to lower back
- Nausea & vomiting
- Bloody urine.
2. What can cause Kidney Stones?
The causes of kidney stones vary, and men develop them twice as often as women. If someone else in your family has or has had kidney stones, then the likelihood to form stones is increased. Once a person has their first kidney stone, they have approximately a 50% chance of developing another stone sometime later in life. A change in diet may decrease the chance of forming stones, if diet was a contributor to the formation of the stone originally.
3. How can Kidney Stones be prevented?
The primary way to prevent kidney stones is to drink plenty of fluids, ideally water. Some types of foods may be eaten in moderation and may decrease the chance of forming another stone, i.e. foods high in calcium (totally avoiding calcium, even if the stones are composed of calcium may do harm, since calcium is important in the body's function). There are medications that help prevent the development of certain kidney stones. Catching the stone so it may be analyzed for its composition is very helpful in knowing how and what to do to prevent further stones.
4. How are Kidney Stones evaluated?
When a patient experience symptoms common to kidney stones, tests are done to determine if a stone is present. A urinalysis will be taken to look for blood, crystals, or infection. An intravenous pyelogram (IVP) or CT Scan will be ordered to confirm the diagnosis of a kidney stone, and also to check the location of the stone. If an individual is allergic to iodine, an ultrasound of the kidney will be ordered.
5. How are Kidney Stones treated?
The good news is that the majority of stones do not require surgical intervention. The most common way to treat stones that will not pass on their own is Extracorporeal Shock Wave Lithotripsy (ESWL). ESWL is an outpatient procedure performed under intravenous (IV) sedation, using a high energy machine that delivers shock waves directed by live X-ray to the stone, resulting in the stone breaking into smaller pieces. These smaller pieces of the stone will pass into the bladder, and the patient will pass the fragments when urinating.
About 20% of the stones will not break into smaller pieces or will fail to pass out of the patient, then surgery will be needed. The two most common surgical interventions are:
- Ureteroscopy - This procedure may be performed if the stone is located in the ureter. An instrument, like a small telescope, is passed through the urethra and bladder up to the stone. Then the urologist can use a laser to break up the stone, a small wire "basket" to grab and remove it, or other methods may be better suited for the location and size of the stone. These procedures do require anesthesia, and the patient is usually an outpatient at a hospital.
- Percutaneous nephrolithotripsy - A surgical approach less commonly done, this involves a stone breaking laser instrument that is passed directly into the kidney through an incision and tube placed in the patient's back. This is usually done for very large stones that cannot be treated in any other fashion. The patient is usually admitted into the hospital and will stay 1-2 days depending on recovery.