Dr. Lievano is a Urology doctor serving the DFW metroplex. His primary office location is at Baylor Scott & White in Fort Worth, Texas.
Although kidney stones are more common in males than females, they can affect anyone. They’re often caused by low fluid intake, dehydration, high salt intake, and elevated protein consumption. Metabolic abnormalities can also lead to kidney stones. High calcium oxalate, uric acid or cysteine levels could also contribute to kidney stones.
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What Are Kidney Stones?
Kidney stones are mineral deposits that remain in the kidneys after they filter the blood. They may be smaller than a pea, but they can cause painful symptoms as they start to move through the ureter, the tube that transports urine from the kidney to the bladder.
Once you have a kidney stone, you’re more likely to develop another. Certain diseases can increase your chances of developing the painful condition.
According to the American Kidney Fund, your likelihood of getting kidney stones is heightened if someone in your family has had the condition. Other risk factors include:
- Being overweight or obese
- Having some type of kidney disease
- Having a condition that causes urine to contain high levels of certain minerals
- Having a condition that causes inflammation in the bowels or joints
- Taking diuretics or calcium-based antacids
Symptoms Of Kidney Stones
Small kidney stones may not cause symptoms. If you do have signs of a kidney stone, they may include:
- Sharp pain in the back, side or abdomen
- Pain while you urinate
- Urgent need to urinate
- Blood in urine
- Cloudy or stinky urine
- Low urine volume
- Nausea and vomiting
Kidney stones can cause serious complications if they’re left untreated. A kidney stone can develop into an infection. If this has occurred, you might have fever and chills. A kidney infection requires immediate medical attention.
Kidney Stone Treatments
There are various ways to treat kidney stones. The best type of treatment depends on the size and composition of the stone. The location may affect the type of treatment that you get. A stone that is blocking the urinary tract may be handled differently than one that remains inside the kidney.
Diagnosing Kidney Stones
Your urologist may order diagnostic tests to determine the best course of treatment. These include:
- Urine tests
- Blood tests
- CT scans
The test results can show the size and location of the stone. A small stone may be flushed through the urinary tract with plenty of fluid. Doctors may prescribe pain medication if this becomes painful.
Shock Wave Lithotripsy
A large or obstructive stone usually requires you to undergo more intensive treatment. Shockwave lithotripsy is the most common treatment for kidney stones in the U.S. It’s a noninvasive procedure that involves sending shock waves from the outside of the body to the kidney stones. These waves break up the deposits into fragments that are small enough to pass with the urine.
The treatment can be repeated if it doesn’t cause large stones to crumble after the first procedure. It’s most effective on stones that are smaller than 2 cm in diameter.
Even though this procedure doesn’t involve a surgical incision, it may cause pain. Some type of anesthesia is used to ensure that you remain comfortable and improve the urologist’s chances of breaking up the stone. Recovery time is fairly brief.
Ureteroscopy And Cystoscopy
A ureteroscopy is more invasive than shock wave lithotripsy. During this procedure, a urologist will insert a flexible tube into the urethra while the patient is under general anesthesia. The scope will move up to the ureter, giving the surgeon an exact view of the location of the kidney stone.
If it’s small enough, the stone can be removed during the procedure. Larger stones may need to be broken up with a laser before they can be passed through the urinary tract.
Doctors can also remove or treat polyps, tumors or abnormal tissue while they’re performing a ureteroscopy. In some cases, a ureteroscopy is used to perform a biopsy of the ureter or kidney.
A cystoscopy is a similar procedure that uses a shorter tube to view the bladder and urethra. This can pick up stones that have moved into these areas.
When other methods for treating kidney stones aren’t effective, a percutaneous nephrolithotomy may be necessary. This procedure is also used to treat large stones.
Imaging is usually performed before the procedure to determine the exact location of the stones. Then, the patient is put under general anesthesia.
The surgeon will make a small incision in your back and insert a tube into the incision. A camera is inserted into this tube and allows the doctor to find and remove the stones. This type of treatment requires a longer hospital stay than the other types and may lead to a longer recovery time.
As with any surgery, the patient should be monitored for infection and bleeding after the procedure. A stent may be inserted to help urine drain and encourage healing.
Testing Kidney Stones
After you pass a kidney stone or have it removed, your doctor may send it to a lab for evaluation. Determining what the kidney stone is made of can help you learn what caused it and determine the best way to prevent new ones from forming.
If your kidney stones contain high levels of calcium, then you’re likely excreting too much of that mineral. This can be hereditary or caused by a diet that’s too high in calcium. An imbalance in nutrient absorption can also lead to these types of kidney stones.
Uric acid stones are usually caused by uric acid metabolism disorders, such as gout. Struvite stones indicate that patients may have a bacterial infection that causes them to produce too much ammonia. Some types of kidney stones are caused by the consumption of certain medications.
How Urgently Should You Be Treated?
While kidney stone surgery is not always necessary, doctors may hurry to treat you if:
- You have only one kidney
- You have a urinary blockage
- You have had a kidney transplant
- You have large or multiple stones in both kidneys
- You are in severe pain
- Your kidney function is threatened