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Kidney Stones

Kidney stones are painful and somewhat common. Statistics point to the fact that more than 30 million Americans have suffered from urolithiasis, or stone disease, at some time in their lives. If waiting for a stone to pass fails, we can treat kidney stones by using shock wave lithotripsy, ureteroscopy, percutaneous nephrolithotomy or open surgery. In any case, we have a variety of tools with which to help male and female patients with kidney stones.

Kidney stones occur when the urine becomes excessively concentrated with a substance which then crystallizes out of the urine onto the wall of the kidney instead of staying dissolved in the urine. It may pass into the ureter, the thin tube which passes the urine from the kidney into the bladder, as a very small crystal. This crystal greatly irritates the inner wall of the ureter causing severe symptoms. It may also block the ureter stopping the flow of urine and cause the kidney to back up with urine and painfully enlarge.

Symptoms of kidney or ureter stones include:

  • Severe, sharp flank pain which may come in waves and radiate into the groin or lower abdomen
  • Pain or burning upon urination with a persistent need to urinate
  • Urine which is cloudy, has an odor, or is discolored
  • Nausea, vomiting, fever, chills upon occasion

Causes and risk factors for stone formation include:

  • Family or personal history of stone formation
  • Dehydration from not drinking enough fluids or by loss of fluid such as diarrhea, inflammatory bowel disease, diabetic passing of excess sugar in the urine, excessive sweating
  • Diet that is high in salt, sugar, or animal protein
  • Obesity
  • Other medical conditions such as post gastric bypass surgery, kidney disease, hormonal problems such as hyperparathyroidism which affects the calcium levels in the body
  • Excessive use of antacids containing calcium, vitamin C, and use of some migraine/depression medications

To diagnose, your AUCNY urologist will use some of the following:

  • Detailed history and physical examination – requesting details on symptoms, personal and family medical history, social history including smoking habits, physical examination with special emphasis on the bladder area including rectal/pelvic exam
  • Blood test to measure calcium, uric acid, hydration, and measures of kidney function in general
  • Urine test which may include a 24-hour urine collection to analyze the substances and their concentrations in the urine
  • Imaging procedures (X-ray, CT, MRI, and ultrasound)
  • Analysis of passed stones that the patient strains from their urine as it is voided through a strainer (to isolate the stone as it is passed out the urethra). The stone is then analyzed by our lab to determine its composition (calcium, uric acid, oxalate, struvite) which aids your AUCNY urologist in determining the cause of the stone formation. This information guides both the treatment and subsequent prevention of future recurrences.

Treatment Options

Treatment for small kidney stones may consist of the following:

  • Increasing water intake to help flush out the stone and dilute the causative substance
  • Pain medication to make the passage of the stone through the ureter more tolerable
  • Prescription medications like the alpha blockers, tamsulosin (Flomax) or dutasteride to relax your muscles to help pass the stone

For larger kidney stones that will not pass on their own, other treatments that may be offered by your AUCNY doctor are:

  • Extracorporeal shock wave lithotripsy (ESWL)– sound waves are used to break the kidney stones into very small particles that will pass through your urine
  • Lithotripsy– uses shock waves to break up the kidney stones so they can pass through your urinary system
  • Ureteroscopy/laser surgery– a minimally invasive surgery using laser beams to destroy the ureteral stones
  • Percutaneous Nephrolithotomy– a procedure using small instruments and a tube to directly remove kidney stones

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