Education & Diagnosis
Kidney stones are one of the most common and painful disorders of the urinary tract. A kidney stone is a hard mass developed from crystals that separate from the urine and build up on the inner surfaces of the kidney. Urine contains chemicals that prevent or inhibit the crystals from forming. These inhibitors do not seem to work for everyone, however, so some people form stones. The stones can vary in size from a grain of salt to a golf ball. Small stones can travel through your urinary system and pass out of your body in your urine without pain. Larger stones usually start to cause pain and other symptoms when they move around in your kidneys or into other parts of your urinary system and begin to block the outflow of urine.
There are such thing as “Silent Stones” that do not cause symptoms, but in most cases Kidney Stone symptoms include:
- Extreme pain in your side and back, below your ribs
- Pain that spreads to your lower abdomen and groin area
- Pain that comes and goes and changes in intensity
- Nausea, vomiting, fever or chills
- Pink, red or brown urine
- Burning sensation during urination
- Cloudy or bad smelling urine
- Persistent urge to urinate or urinating more than usual
Testing & Treatment
An X-ray or CT scan will reveal the location, size and number of stones, all of which will be used to determine appropriate treatment.
Small Stones: If your stone is small, your doctor may recommend you try to pass it through the urinary system with plenty of water (2 to 3 quarts a day) to help move the stone along. Normally, your doctor will prescribe a pain medication to help with the discomfort and a medication to help relax your ureters to allow the stone to pass.
Most kidney stones can pass through the urinary system with plenty of water (2 to 3 quarts a day) to help move the stone along. The doctor usually asks you to save the passed stone(s) for testing.
Large or Complicated Stones: If your stone is too large to pass, blocking the flow of urine or causing other complications, your doctor may recommend one of these treatments.
- Shockwave Lithotripsy: In an outpatient surgery setting, your urologist uses a machine called a lithotriper to direct ultrasonic shock waves to hit the stone repeatedly until it crumbles into small particles that you can pass in your urine. This is the most frequently used procedure for eliminating kidney stones.
- Ureteroscopy: In this procedure, your urologist passes a flexible tube with a camera through your urethra. A wisk-like basket on the end of the scope snares the stone and removes it. If the stone is too large, the urologist can use a laser inserted through the scope to break the stone apart. After a ureteroscopy, the urologist places a stent in the ureter to hold it open until the swelling subsides. The stent is removed a days later.
- Percutaneous Nephrolithotomy: For large stones that can't be effectively treated with lithotripsy or ureteroscopy, your urologist can perform a minimally-invasive surgery through a 1 centimeter incision in your back. Using a scope and special tools, the urologist can break apart the stone and suction it out.
If you've had more than one kidney stone, you are likely to form another; so prevention is very important. To prevent stones from forming, your doctor must determine their cause by performing a urine and or blood test. Analysis can also be done on stones passed and urine discharged following the stone passing. To minimize your chances of getting additional stones, follow these guidelines:
- Drink water. Water helps keep your urine from becoming too concentrated and forming crystals. A good rule of thumb is to drink enough water to keep your urine a faint yellow color.
- Limit salt. Salt, which is often found in processed foods, can lead to dehydration, causing your urine to become too concentrated.
- Avoid certain foods. For calcium stones, the most common type of kidney stones, avoid foods with high amount of oxalate including coffee, tea, chocolate, wheat bran, spinach, and strawberries.