WHAT ARE KIDNEY STONES?
Kidney stones, also known as renal calculi, are hard deposits of minerals and salts that form inside the kidneys. There are many possible causes of kidney stones. Diet, obesity, supplement and/or medication intake or other medical conditions can cause kidney stones to form in your body. Kidney stones may be more prone in patients whose urine contains more crystal-forming substances such as calcium, oxalate and uric acid than the urine can dilute.
SYMPTOMS OF KIDNEY STONES
A kidney stone can sometimes by asymptomatic until it moves around the kidney or comes into the ureters which are the tubes connecting the bladder and the kidneys. In some cases, the stone can lodge in the ureters and block the flow of urine. This will cause hydronephrosis which is the swelling of the kidneys. By this stage, the kidney stone can cause severe pain in patients. Patients can experience intense, sharp pain in the side and back just below the ribs. They may also experience pain that radiates to the lower abdomen and groin area. The pain may come in waves and vary in intensity. Lastly, patients may experience blood in urine as well as burning sensation while urinating.
DIAGNOSING KIDNEY STONES
A computed tomography (CT) scan is often used to diagnose urinary stones. An X-ray can also be used to diagnose urinary stones. The position of the stone and the extent to which the stone is blocking the urinary tract can be seen on the images from the CT scan or X-ray
TREATMENTS FOR KIDNEY STONES
Treatment will depend on the type, size and location of the stone. It will also depend on the symptoms that patient has. Sometimes, small kidney stones do not require invasive treatments. The kidney stones may pass out of the body by drinking water. Pain relievers can be given during this process to help manage the pain. The doctor may also give an alpha blocker medication that helps relaxes the muscles in the ureter. This will help the kidney stone pass more quickly and with less pain. If the kidney stone is making the patient rather symptomatic and causing a lot of pain and discomfort, the doctor may suggest treating the stone. There are a few treatment options:
- EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY (ESWL)
ESWL uses sound waves to create strong vibrations (shock waves) that break the stones to smaller fragments that can be passed in your urine. However, depending on the type and size of stone, this treatment may not be suitable. The doctor will assess the patient before recommending the best treatment to ensure a better stone clearance rate.
- URETEROSCOPY AND LASER LITHOTRIPSY (URS & LL)
A thin lighted scope known as the ureteroscope is inserted through your urethra and bladder to your ureter. Once the stone is located, a laser beam will break it into pieces that will then be passed in your urine. A stent is inserted in the ureter to relieve swelling and help healing. This is the most common endoscopic procedure performed for the treatment of kidney stones which provide patients a quick relief of symptoms.
- PERCUTANEOUS NEPHROLITHOTOMY (PCNL)
PCNL is a minimally-invasive procedure which involves surgically removing a kidney stone using small instruments inserted through a small puncture wound in your back. This procedure is typically for larger kidney stones. It is usually done under general anesthesia.
- MINIMAL INVASIVE PERCUTANEOUS NEPHROLITHOLAPAXY (Mini-PCNL)
Mini-PCNL is a minimally-invasive endoscopic procedure to remove kidney stones. It is used for larger kidney stones or if other therapy methods such as ESWL have not been successful. A special miniaturized instrument is used for this procedure. The surgery is usually done under general anesthesia. After contrast medium imaging of the kidney tract on the effected side, the kidney is then punctured directly through the skin. The puncture is controlled via fluoroscopy and ultrasound. After dilating the puncture canal, the endoscope is inserted into the kidney. With a special laser, the kidney stones are broken up and washed out.