Understanding Kidney Stones

When it comes to kidney stones, there is much that is misunderstood. Stones can be caused by many different things and they are more prevalent in some people than in others. For instance, they are more prevalent in men than in women, and are much more likely in a pregnant woman than in a woman who isn't pregnant and yes, sadly, even children can get them.

There are many risk factors to stones. These include low water intake, heavy salt and oxalate intake, some specific medications, and vitamins, diet and genetics. The Southern diet is unfortunately a big factor in the formation of stones. Family history, lifestyle and fluid intake all may play a role in kidney stone formation.

Stones in our practice are typically composed of calcium oxalate, uric acid, or struvite. There are also cysteine stones, which are usually genetic and usually strike earlier in life. All stones start small and may continue to grow in size. Some individuals are able to pass their stones without any medical intervention. However, others will require medical or surgical intervention to extract the stones (calculi).

Symptoms of a Kidney Stone

Many equate the passing of a stone in the kidney to that of giving birth. If you have a stone, you're likely to have one or more of these symptoms:

• Severe flank or abdominal pain

• Blood in your urine

• Nausea and vomiting

• Increased urinary urgency/frequency

• Burning upon urination

• Pain radiating to the testicles or head of the penis (in men)

• Chills and fever

Diagnosis of a Kidney Stone

Diagnosis is made by seeing a doctor who may order one or more of the following tests:

• CT scan

• X-rays on the abdominal/pelvic region (KUB)

• Urinalysis

Treatment of a Kidney Stone

The initial treatment option may include a "wait and see" attitude if the stones are small and have a good chance of passing. We will likely recommend “medical expulsive therapy” with hydration, analgesia, and straining of the urine to capture any stone particles.

Other options include shock wave lithotripsy, a non-invasive treatment where the stone is “busted up to dust” through sound waves focused on the stone through a water medium, or minimally-invasive endoscopic procures like ureteroscopy, where a small camera is inserted through the urethra to reach the stone in the ureter or kidney. A laser is often inserted to break up the stone, and then allow the urologist to remove the fragments with a basket. A temporary stent is usually required for a week or so after this procedure, which is removed in the office.

One last (and rare) option for very larger stones in the kidney (larger than 1 inch) is percutaneous surgery, where a small tube is placed through the skin into the kidney itself, and ultrasound waves are used to pulverize the stone.