Urinary or Kidney stones are hardened mineral deposits that gather on the way from the renal pelvis in the kidney to the bladder. These originate as microscopic particles and over the course of time develop into stones. Medically this condition is known as nephrolithiasis, or renal stone disease. The kidneys filter waste products from the blood and adds them to the urine. When waste materials in the urine do not dissolve completely and the kidney is unable to evacuate them, crystals and kidney stones are likely to form. Some stones may pass out of the kidney or get lodged in the ureter (tube that carries urine from the kidney to the bladder), and cause severe pain that starts from the lower back and radiates to the side or groin.

Kidney stones can provoke a severe, sudden pain if they move along the ureter, the tube leading from the kidneys, and they can cause a lot of health problems if they block the flow of urine. The pain can often be accompanied by vomiting. If they move into the ureter (the tube from the kidney to the bladder) they cause intense pain and blood in the urine. A lodged stone can block the flow of urine and build a backpressure in the affected ureter and kidney. Increased pressure results in stretching and spasm, which cause severe pain.

Kidney Stones

Types of Kidney Stones

  • Calcium Stones
    Calcium stones are the most common type of stones. Calcium is a normal part of a healthy diet and is used by bones and muscles. Calcium not used by the body goes to the kidneys where it is normally flushed out with the rest of the urine. In some people, however, the calcium that stays behind joins with other waste products to form a stone.
  • Struvite Stones
    Struvite stones are a type of stone that contains the mineral magnesium and the waste product ammonia. It may form after an infection in the urinary system.
  • Uric Acid Stones
    Uric acid stones may form when there is too much acid in the urine.
  • Cystine Stones
    Cystine stones consist of cystine, one of the building blocks that make up muscles, nerves, and other parts of the body, can build up in the urine and form a stone. Cystine stones are rare. The disease that causes cystine stones (cystinosis) runs in families.

Signs & Symptoms

Small and smooth kidney stones may remain in the kidney or pass without causing pain (called “silent” stones). Stones that lodge in the ureter (tube that carries urine from the kidneys to the bladder) cause the urinary system to spasm and produce pain. The pain is unrelated to the size of the stone. Other symptoms of kidney stones may include the following:

  • Blood in the urine.
  • Increased frequency of urination.
  • Nausea and vomiting.
  • Pain and burning during urination.
  • Fever, chills, loss of appetite.
  • Urinary tract infection.

Diagnosis of Kidney Stones

In addition to a complete medical history and physical examination, diagnostic procedures for kidney stones may include the following:

  • Intravenous Pyelogram (IVP)
    A series of x-rays of the kidney, ureters, and bladder with the injection of a contrast dye into the vein – to detect tumors, abnormalities, kidney stones, or any obstructions, and to assess renal blood flow.
  • Urinalysis
    Laboratory examination of urine for various cells and chemicals, such as red blood cells, white blood cells, infection, or excessive protein.
  • Blood Tests
    Laboratory examination of the blood to detect substances that might promote stone formation.
  • Renal Ultrasound
    A non-invasive test in which a transducer is passed over the kidney producing sound waves which bounce off of the kidney, transmitting a picture of the organ on a video screen. The test is used to determine the size and shape of the kidney, and to detect a mass, kidney stone, cyst, or other obstruction in the kidney.

Treatment of Kidney Stones

  • Extracorporeal shock wave Lithotrispy (ESWL)
    Extracorporeal shock wave Lithotrispy (ESWL) uses highly focused electro magnetic waves projected from outside the body to crush kidney stones anywhere in the urinary system. The stone usually is reduced to sand-like particles that can be passed in the patient’s urine. Large stones may require more than one ESWL sessions. The procedure should not be done for pregnant women. It can be used for patients of all age groups and those who have heart and breathing problems. ESWL by 4th generation “Siemens Lithotriptor” with Ultrasound attachment helps to treat even Radioluscent stones, which are not visible in normal fluoroscopy Lithotriptors.
  • Percutaneous Nephrostolithotomy (PCNL)
    Percutaneous Nephrostolithotomy (PCNL) This minimal invasive procedure is performed under local anesthesia. Percutaneous (i.e., through the skin) removal of kidney stones (lithotomy) is accomplished through the most direct route. A telescope along with mechanical lithotriptor in inserted to break stone into fine particles to achieve stone-free status in large and complicated stones. This procedure usually requires hospitalization, and most patients resume normal activity within 2 weeks.
  • Ureteroscopic Lithotrispy with Holmium Laser
    This procedure is performed under Epidural and Spinal Anaesthesia to treat stones located in the middle and lower ureter. A small, fiberoptic instrument (ureteroscope) is passed into the ureter. Large stones are fragmented using 100-Watts Coherent Holmium Laser. The laser fragments stone into sand like particles, which are then flushed out through the natural urinary passage. The advantage of Holmium Laser is its ability to fragment stones of all compositions and precision. Thus, it is the most effective laser for the treatment of ureteric stones. Patients are generally admitted the same day of the treatment and are discharged next day, which means only 24 hours hospitalization.

Preventing Kidney Stones

The best ways to prevent kidney stones are the following:

  • Drink at least eight to 10 cups of water a day, and eat a healthy, well-balanced diet.
  • Dietary changes may be advised to prevent recurrence. Specific changes-such as avoiding sodium, animal protein, and foods containing high amounts of oxalate (found in rhubarb, spinach, leafy vegetables, and coffee) will depend on the type of kidney stone involved.
  • It is important to note that severe dietary calcium restriction is discouraged.
  • Medications such as thiazide diuretics, allopurinol, sodium or potassium citrate, calcium, or magnesium may be administered to help prevent recurrence of stones. The type of medication varies according to the exact composition of the stone.
  • The doctor may prescribe potassium citrate to decrease urine acidity in those with uric acid stones.
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