Urinary Stones

The kidneys are two “bean-shaped” organs, located at the back of the abdomen up under the ribs that help in the removal of wastes from the body.

As the kidneys filter blood of these impurities, minerals and acid salts can accumulate and harden over time.

These solid crystalline deposits are called kidney stones, and can form in one or both kidneys. The stones can travel down the urinary tract and block the flow of urine, causing pain and bleeding.

Kidney stone formation is a common urinary system disorder that can form in any individual. However, men, and overweight people are at a higher risk of developing them.

Causes

Kidney stones form when certain salts and minerals in the urine become highly concentrated and build up. This can happen due to

  • Insufficient water intake (the most common cause)
  • Some treatments for kidney diseases and cancer
  • Certain medications
  • Family history
  • Intestinal disease such as Crohn’s disease
  • “Inbuilt” abnormalities of the way the body and kidneys handle certain minerals and acids

Signs and Symptoms

Symptoms of kidney stone formation may not manifest until the stone moves around the kidney or down into the urinary tract. Symptoms may include

  • Severe pain below the ribs, back, sides, lower abdomen, groin and during urination
  • Pain that fluctuates in intensity
  • Frequent urge to urinate
  • Pink, brown or red urine that is cloudy or foul smelling

You should call your doctor if you find it difficult to pass urine, or the pain increases and is accompanied with fever, chills, vomiting and nausea.

Diagnosis

When kidney stones are suspected, your doctor may order blood, urine and imaging tests (X-ray, ultrasound, CT scans) to diagnose the condition.

You may also be asked to urinate through a sieve to collect and test the kidney stones that pass in the lab.

The results will help your doctor to determine the cause and formulate an appropriate plan for treatment.

Conservative treatment

Treatment depends on the type of stone and its underlying cause. Small kidney stones may be flushed out by drinking plenty of water every day , possibly helped by medications to relax the urinary tube muscles, or , occasionally through medication to dissolve the stones.

Additionally, your doctor may prescribe medication to relieve pain.

Treatment Options

For larger stones, Dr. Love may suggest certain procedures based on the location and size of the kidney stones.

A non-invasive procedure called Extracorporeal Shock Wave Lithotripsy (ESWL) may be recommended to break down large stones. Under an anaesthesic , and after the location of the stones is determined with the help of ultrasound or X-rays, using a device called a lithotripter, high energy sound waves are passed over the area to be treated from outside the body.

The shock waves will vibrate and break the stones down without harming the rest of the body. The stone fragments can now easily pass out through the urine.

Sometimes, Dr. Love may use insert a stent or tube before or after the procedure through the bladder or the back into the kidney to hold the urinary tube open, preventing the pieces from blocking the tube.

Another alternative procedure your doctor may suggest is ureteroscopy.

This can be used for stones in the urinary tract closer to the bladder. A thin lighted tube called an ureteroscope is inserted through your urinary tract opening, so no incisions are needed for the procedure. Once the stone is located, tiny forceps or a basket shaped instrument at the end of the scope grabs and removes the stones. Larger stones are first broken down with a Holmium laser before removal.

Sometimes, a more invasive procedure called percutaneous nephrolithotomy (PCNL) may be performed.

Dr. Love will make an incision in your back under anaesthesia. A hollow tube with a telescope and probe is inserted into the incision, and into the kidney directly.

Dr. Love can either remove the stones directly or break them into fragments before removing them.

Prevention

Kidney stones can be prevented by making some lifestyle changes like drinking more water and reducing the intake of excess salt and animal proteins, although some patients require medications to help prevent more stones.