Medical procedures for kidney stones can range from less-invasive methods such as shock waves to major open surgery. Usually kidney stones pass without medical intervention, but in some cases the stone is so large that no amount of consumed water will ease its passage down the urinary tract. If the stone is still growing, causing bleeding, or blocking the flow of urine leading to infection, medical attention is urgently needed. Yet major open surgery is only performed in less than two percent of cases.  Eighty-five percent of kidney stones pass within two to three days with added water consumption, and the others can be treated with medications and less-invasive procedures to be eliminated. If you seek medical care for a kidney stone, your doctor will probably use X-rays or ultrasound to first determine the location of the stone and later to monitor the stone during treatment. Then a method of treatment will be decided upon depending on your individual situation.

Procedures available for kidney stones include:

• Extracorporeal shock wave lithotripsy (ESWL) uses shock waves or ultrasonic waves to break the stone down into tiny pieces to be passed out in your urine. It is usually used on kidney stones smaller than a half inch located in the kidneys or upper urinary tract. The procedure is not used for cystine stones or larger stones which are over an inch in size (three centimeters). The procedure is often done on an outpatient basis under anesthesia. You may be positioned in a water bath or on a soft cushion while ultrasound waves will generate shock waves to the stone. The shock waves shatter the stone into tiny pieces that will pass out of the urinary tract with urine. Sometimes a stent will be inserted into the ureter to help pass the fragments which can still cause discomfort.
• Percutaneous nephrolithotomy (PNL) removes the kidney stone in the upper urinary tract through a small incision in your back with an instrument called a nephroscope. If the stone is large or ESWL has not been effective, this surgical procedure is often used. Also, it is used for kidney transplant patients or when the kidneys are malformed. Cystine stones can be removed with this method because they tend to be drug resistant and do not respond to shock wave treatment.
• Ureteroscopic stone removal takes out stones lodged in the ureter and works well on stones in the lower part of that tube. A small instrument called an ureteroscope is inserted into the ureter through the bladder. Then ultrasound or laser energy can be directed through the scope to dissolve the stone.
• Parathyroid surgery involves removing one or more parathyroid glands which are located in your thyroid gland below your Adam’s apple. These glands can produce too much parathyroid hormone which causes your body’s calcium level to become too high. An excess of calcium secreted in your urine can lead to the formation of calcium stones. This condition often results from a small benign tumor on one of the thyroid’s four parathyroid glands. Advances in recent procedures for this surgery have reduced the amount of gland tissue removed, in order to leave more tissue which functions properly.
• Open surgery (nephrolithotomy) is performed by a surgeon when other methods have failed or are not appropriate, or when the patient is extremely obese. During the surgery, the kidneys are cooled with ice and X-rays will determine the location of the stone. The surgeon removes the stone and repairs any blockage in the affected area. Recuperation from the surgery can take from four to six weeks. (Placeholder2)

Removed kidney stones will be examined for their composition which can help identify the underlying causes. The complication rate for these procedures is low, usually in the one to three percent range, and kidney failure is extremely rare. It is important to make the lifestyle changes advised by your doctor to help stop the formation of kidney stones. If you have had complications in passing a kidney stone, you most likely will never want to experience again the pain and the medical procedures for kidney stones.

written by Joy Seeman

© 2009 Hemorrhoid Information Center

Sources:

Coe, M. F. (2007, October). Kidney Stones in Adults. Retrieved September 21, 2009, from National Kidney and Urologic Diseases Information Clearinghouse: http://kidney.niddk.nih.gov

Kidney Stones. (2008, January 31). Retrieved September 21, 2009, from Mayo Clinic.com: http://mayoclinic.com

Simon, M. H. (2009, July 27). Kidney Stones. Retrieved September 21, 2009, from About.com: http://adam.about.com

If you have passed a kidney stone, it is an experience that you don’t want to repeat because it probably was the most painful episode of your life. The good news is that usually no damage is done to your body in passing the stone, but the bad news is that once you have produced a kidney stone, the more likely you will have others. It is important to find out what kind of stone you passed, so you can make lifestyle changes to help prevent recurrence.  Kidney stones are a common disorder of the urinary tract affecting millions of people a year, and it is a mystery why the numbers have steadily increased in the last 30 years.

What is a Kidney Stone?

Kidney stones develop from crystals which separate from your urine to form a solid mass. Often these crystals or tiny stones pass in your urine without being noticed. In a healthy individual, the urine contains chemicals that stop the formation of these crystals. However, in some people, a chemical imbalance takes place, and stones are formed. When a stone is passed, it should be strained from the urine and analyzed for its compounds to help determine the underlying causes of why it formed.

Four Types of Kidney Stones:

• Calcium stones are the most common, occurring more often in men than in women. They often appear in early adulthood between the ages of 20-30, and recurrence is common. The calcium bonds with other substances such as oxalate, phosphate, or carbonate to form the hard mass. Diseases of the small intestine can contribute to calcium-oxalate stone formation.
• Struvite stones are caused by an infection in the urinary tract, primarily in women. Large stones can form which may block the bladder, ureter, or kidney. These stones can be in a stag-horn formation, because they fill all the space where they form in the kidney.
• Uric acid stones form mostly in men who have gout or receive chemotherapy. Uric acid is a product of protein metabolism in the body, and can result from high-protein diets. Although, certain genetic factors and disorders of blood-producing tissues can also cause these type of stones.
• Cystine stones are formed by people who have cystinuria, a disorder that runs in families where an excessive amount of certain amino acids are excreted in the urine.

Drinking a glass of lemonade a day can greatly reduce the chances of getting kidney stones again.

♦ Drink more water. This is the most important lifestyle change to make because kidney stone formation is aided by dehydration. Doctors recommend that if you have had a stone, you should drink enough liquids to produce 2.5 quarts of urine in a 24 hour period.

♦ Drink a glass of lemonade every day which increases the levels of citrate in your urine and suppresses kidney stone formation. Use fresh or frozen concentrated lemonade, avoiding powder mixes. Also, avoid cranberry juice because of its high acid content.

♦ Eat less meat, poultry, and fish if you have acidic urine since they raise acid levels. Uric acid and cystine stones form mainly in acidic urine.

♦ Eat foods containing calcium such as dairy products. Recent studies have shown that foods high in calcium may actually help reduce kidney stone formation. This is opposite of what was previously believed. Yet, calcium supplements and antacids are still to be avoided.

♦ Increase potassium intake from dietary sources, such as bananas and lima beans, which lessens calcium stone formation.

♦ Lose weight. Obesity and weight gain are risk factors for kidney stones.

♦ Reduce stress in your life. One study found that people who reported having stressful situations had more kidney stones. This may be due to stress hormones released into the body which also contribute to stone formation.

♦ Avoid foods containing oxalate if you form calcium-oxalate stones. Some foods containing the compound are Swiss chard, spinach, peanuts, and chocolate.

Passing a kidney stone is one of the most painful experiences known, and if it has happened to you, you want to take steps to avoid a recurrence. Fortunately, with the analysis of the type of stone passed, many lifestyle changes can lessen your chances of it happening again. Be sure to follow your doctor’s advice for your particular health situation.

written by Joy Seeman

©  Hemorrhoid Information Center 2009

Sources:

Coe, M.D., Frederic .  (2007, October). Kidney Stones in Adults. Retrieved September 19, 2009, from National Kidney and Urologic Diseases Information Clearinghouse: http://kidney.niddk.nih.gov

Kidney Stones. (2008, January 31). Retrieved September 18, 2009, from Mayo Clinic.com: http://mayoclinic.com

Simon, M.D., Harvey.  (2009, July 27). Kidney Stones. Retrieved September 19, 2009, from About.com: http://adam.about.com