Kidney Stones Treatment Information
Introduction
Kidney stones are very common and many stone forming patients get frequent attacks of stone pain . There are many different reasons why you would form a stone e.g. diet, poor fluid intake, medical conditions, family history, genetic/inherited conditions, however the rapid rise in western countries is thought by many to be attributed largely to our diet and obesity.
Stones can be extremely painful, and often the patient journey from pain to diagnosis and treatment can be a traumatic and extremely disruptive to normal life. Especially with repeated procedures.
Kidney stones can also be completely without any symptoms.
Stones tend to reoccur frequently, and even silent stones can become painful or grow into larger ones with time.
Not everybody needs surgery however, and some stones have a high chance of passing with the help of pain medication and some time.
My philosophy on treating stones is to try clear the stones completely, rendering patients stone free. Patients usually get a stone analysis and a basic metabolic assessment to ensure there are no unrecognised medical conditions that has led to the stone, and which may need referral to another specialist (e.g. the condition hyperparathyroidism, vitamin D deficiency etc). I categorise the patient into low and high risk for forming new stones in the future. If patients are low risk, then my advice will be based around fluid intake and general dietary advice. If patients are high risk for forming stones, I recommend undergoing formal 24-hour urine collection. This is where you collect your urine in a container for 24 hours, and it gets analysed in a laboratory for stone forming factors. When I examine the results of this, I can give specific advice on stone prevention, or recommend you start taking medications that can prevent stones from forming.
I have put together an information sheet here that explains kidney stones, the anatomy of your kidneys and the terminology doctors will use to explain your condition to you, the types of surgery that you may require, medications I use to prevent stones and their side effects and diet sheets that I use to explained to patients what foods to avoid depending on the type of stone they form. I hope you find this useful.
Types of Treatments for Kidney Stones
Shockwave Lithotripsy (“ESWL”)
Shock waves delivered from outside the body are used to break up the stone. Generally, ESWL is used for patients who have kidney stones that have not passed on their own, and that can be seen with X-rays. These stones could be located in the kidney or ureter. In some situations, an urologist may need to insert a tube or stent prior to lithotripsy. In some cases, there may be specific reasons not to perform ESWL, and another procedure may be more appropriate.Shockwave lithotripsy (ESWL) is an excellent treatment for many patients with kidney stones, but not all. It is one of a number of different treatment options for kidney stones, and each treatment has benefits and drawbacks.
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Ureteroscopy
One method for removing kidney stones is to insert a very thin telescope, called an ureteroscope, into the urinary passage and up the ureter to break up and remove stones.There are two types of ureteroscopes: rigid and flexible. Rigid ureteroscopes are more common and can usually only be used in the bottom half of the ureter. Flexible ureteroscopes can be sent all the way up into the kidney, but there are certain technical limitations which can make it more difficult to treat larger stones high in the ureter or kidney.
The procedure is generally performed under a general anaesthetic in the operation room. Patients generally return home the same day. A stent is often inserted before or after the procedure and left for a few days to prevent pain or discomfort from swelling.
Ureteroscopy is a safe and effective way of treating stones in the ureter and smaller kidney stones. It is often used as the first treatment for stones in the bottom portion of the ureter that do not pass on their own. It is also the best treatment for patients with stones in the ureter who have had unsuccessful shockwave lithotripsy (SWL) treatments, or who have stones that cannot be seen with X-rays since such stones are difficult to treat with SWL.
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Percutaneous Nephrolithotomy
Patients with large kidney stones or staghorn calculi may benefit from a surgical procedure called a percutaneous nephrolithotomy (PCNL). This procedure is done under a general anaesthetic and involves a small incision in the back where a tube can be inserted into a kidney. A special telescope called a nephroscope is inserted to locate the stones. Through the nephroscope, various instruments can be inserted to break up and remove stones.This procedure generally involves admission to hospital for two to five days. After surgery, a catheter remains in the bladder over-night, and a nephrostomy tube remains through the small incision in the back. The nephrostomy tube is usually removed prior to the patient’s release from hospital.
The procedure is highly effective for eliminating large stones.
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Kidney Stones Informational Videos
Click on the videos below to find out more on kidney stones and how they are treated
External Shock Wave Lithotripsy for stones
Overview of kidney stones and treatments
PCNL - Percutaneous (via the skin on your back) Nephrolithotomy
Overview of kidney stones and treatments
How do kidney stones form
Click on the links below to find out more on Kidney Stones
