FAQ’s for Kidney Stone

If you are having first episode of pain it may be quite severe, frightening and confusing. It is usually described as the worst pain someone has ever experienced. You may need to visit hospital emergency to get analgesic injection and get an ultrasonography and X ray KUB done. Pain is usually on side (flank) and may be associated with nausea and vomiting.

Most doctors feel that kidney stones only cause pain if they are blocking the ureter and trying to pass down towards the bladder. Ureter is thin tube, which carries urine from kidney to urinary bladder. Stones that are not obstructing, such as those located in the kidney’s calyxes, are generally thought to be non-painful. This explains why some patients can have extremely large stones filling up their entire kidney with no or minimal pain.
However, it does appear that some non-obstructing stones can cause pain because of either blockage of small tubular structures in the kidney itself (the collecting tubules) or for other unclear reasons.

Kidney stones affect 1 out of 10 people during their lifetimes. They are more common than most people realize. There are many factors that determines whether someone will develop a stone with some being under a person’s control while others are out of their hands. Common factors influencing kidney stone development:

• Gender: Men are two to three times more likely to form stones
• Race: Caucasians have the highest stone rates as compared to other races
• Age: Stones occur most commonly between the 20s to 50s
• Geography: Those living in hot dry environments are at increased risk. Additionally, those living in the Southeastern United States appear to be at particularly increased risk of forming stones.
• Seasonal climate: Stone development is more common during the summer months due to dehydration from higher summertime temperatures and possibly also from higher concentrations of calcium in urine resulting from increased sun exposure which can lead to higher levels of Vit D production.
• Occupation: Those working in jobs with exposure to climate and dehydration are more prone to stone development.
• Body weight: There are higher rates of stones in those with increased weight and body mass index.
• Genetics and medical conditions: Individuals with a history of some conditions, such as medullary sponge kidney or renal tubular acidosis are prone to forming stones. Those with a personal family history of stones may have two to three times increased risk of forming stones.
• Infections: Chronic urinary tract infections can lead to the development of infection related stones, known as struvite stones.

We are not offering laparoscopic radical cystectomy ) for muscle invasive bladder cancer and laparoscopic radical prostatectomy. We do ir robotically or in open way.

Patients often ask whether something can be taken to dissolve their stones. Unfortunately, the most common stone types (calcium oxalate and calcium phosphate, accounting for 80% of all stones) cannot be dissolved with medications.
However, in patients with uric acid stones, which account for 5-7% of stones, medication (potassium citrate) can be successfully given to dissolve the stones, helping them to pass and preventing them from re-developing.
Patients with the less common cystine type stones (1-3% of stone formers) can also benefit from potassium citrate and water intake to help dissolve their stones. Cystine stone formers additionally can be treated with D-penicillamine or α-mercaptopropionylglycine to help bind and dissolve their stones.

Diet is not the only factor which causes stone formation. There are other factors also which make the patients prone for developing stone. A non-stone-former can eat the exact same diet as a stone-former and never get stones.
Still, diet plays an important role in the prevention of future stones. There are three main factors in the diet, which can reduce future stone formation: increase total fluid intake, decrease sodium intake, and and decrease protein (meat) intake.

Yes!, there are many effective ways to help prevent another stone. Basic dietary changes can reduce your chances of forming another stone by half while more involved medical treatment can reduce that even further. While these changes may not guarantee that you will not form another stone, they can make it less likely that you will have to experience another painful stone episode.

Treatment options for stones include allowing a stone to pass by itself, using medications to help pass a stone, and surgery to treat or remove a stone.

If you have any of the following , consult a urologist immediately.

• Fever above 101.5 degrees Fahrenheit
• Other symptoms of a urinary tract infection with a stone, including burning during urination, cloudy urine, or bad smelling urine
• Persistent nausea and vomiting
• Intolerable pain
• Certain medical conditions can make passing a stone potentially more dangerous, including those with only one kidney, those with diabetes, or those with decreased kidney function

In general, the chances of developing another stone is about 40-50% over five years. In other words, 1 out of 2 new stone formers should expect to develop another stone within the next five years.

Your likelihood of passing a stone will primarily depend on its size, its location, and how long you have been trying to pass a stone.

There are three common surgeries for stones. These include ureteroscopy, shockwave lithotripsy, and percutaneousnephrolithotripsy. ( see kidney stone)

A stent is a thin hollow tube placed inside the ureter to allow urine to drain around a stone and helps the ureter heal after surgery. It is entirely inside your body and can bee seen only on x-ray. Patients may have burning urination and frequent urge to pass urine because of the stent.

Ureteralstents are usually placed during cystoscopy in operation theater by a urologist. It has two curled end. One end stays in kidney and other in urinary bladder after the placement. At each end of the stent are natural “curls” to keep it in place until it is removed or exchanged.

Stent are removed as day care procedure. He taken into operating room again and cystoscopy is done under local anesthesia or mild sedation and stent is grasped with forceps and removed. After 2-3 hrs patient goes home.