Kidney Stone Removal

Kidney stones are hard deposits of minerals like calcium or any other waste products such as uric acid. These stones form inside your kidneys. They start small but can grow bigger as more minerals and waste products stick to them. Kidney stones can affect any part of your urinary tract. It can be from your kidneys to your bladder. 

Some kidney stones will pass without any treatment. Other stones will grow bigger and stick to your urinary tract. You will then need surgery to remove these. 

Kidney stones occur when the urine in your body becomes concentrated. Because of this, minerals will crystalize and stick together. 

What causes kidney stones?

There is no definite cause of kidney stones. They occur when your urine contains crystalline substances. These could be calcium, uric acid, and oxalate. These substances will stick together and form kidney stones. 

Types of kidney stones

If you know the type of kidney stone you have, it will help the doctors identify the cause and help prevent it better. There are four types of kidney stones. These include:

• Struvite stones - These form due to urinary tract infection. Struvite stones can grow large in a short amount of time with very few symptoms.
• Calcium stones - Most of the kidney stones are calcium stones. These come in the form of calcium oxalate. 
• Uric acid stones - These stones form in people who lose a lot of fluid due to chronic diarrhea or people who eat a high-protein diet. There are certain genetic factors that could increase your risk of uric acid stones. 
• Cystine stones - These stones form in people who have the hereditary disorder, cystinuria. It causes the kidneys to excrete too much amino acid. 

Kidney stone risk factors 

Certain factors that can increase your risk of kidney stones include:

• Dehydration - If you don’t drink enough water, your risk of developing kidney stones is higher. 
• Family history - If someone in your family has kidney stones, you are more likely to have it. If you have had it before, there is a high chance you can develop it again. 
• Obesity - If you are overweight or obese, you are more prone to having kidney stones. 
• Digestive diseases - Gastric bypass surgery or inflammatory bowel disease can cause changes in your digestive processes. It will increase the amount of stone-forming substances in your urine. 

Symptoms of kidney stone

• Pain while urinating
• Nausea and vomiting 
• Pain that radiates to your lower abdomen and groin
• Sharp pain in the side or back of your ribs
• Blood in your urine 
• Fever and chills if an infection is present 

Kidney stone diagnosis 

Your doctor will run certain diagnostic tests and procedures to confirm if you have kidney stones or not. These tests will include:

• Blood testing - These tests will show if there is too much calcium or uric acid in your blood. Blood test results will show your doctor how healthy your kidneys are.
• Imaging - Imaging tests will show if there are any kidney stones present in your urinary tract. 
• Urine tests - A 24-hour urine collection test will show if you have a lot of stone-forming substances in your urine.
• Analysis of passed stones - Your doctor may ask you to urinate through a strainer to catch any stones that you pass. Lab analysis will show your kidney stones and their composition. It will help the doctors determine the cause behind it. 

Treatment for kidney stone

The treatment for kidney stones will depend on the size of the stone, the type of stone, and its cause.  

A lot of the kidney stones don’t require treatment. You can pass small stones by:

• Drinking water - Staying hydrated will keep your urine dilute, and it will prevent any new stones from forming. Drinking up to 1.8 to 3.6 liters of water every day will help you pass any of the kidney stones you have in your urine. 
• Medical therapy - Your doctor will give you medication to help pass your kidney stone. These medications are alpha-blockers. It relaxes the muscles present in your ureter, which will help the kidney stones to pass more quickly. 
• Kidney stones that are too large to pass out will cause bleeding, kidney damage, or any ongoing urinary tract infections. Such cases need extensive treatment. These include

Percutaneous nephrolithotomy (PCNL)

It is a minimally invasive surgery to remove large kidney stones. It is for cases where

• Kidney stones larger than 0.8 inches (or 2 cms) in diameter
• There are large stones in the uterer
• Stones are blocking the collecting system of the kidney

During this procedure, you will be under general anesthesia. Your doctor will make a small incision in your back to get access to the kidney stones. They will pass a thin tube into your ureter. This tube has special tools that can break the kidney stone into pieces. These broken pieces will then pass in your urine. Your doctor will also use a small tube (stent) in the ureter, which will help relieve the pain. It will also prevent any swelling. 

You will need to be in the hospital for 2-3 days after the procedure. You should avoid heavy lifting, hard manual work for 3-4 weeks after the procedure. 

Extracorporeal shock wave lithotripsy (ESWL)

This treatment involves using shock waves to remove kidney stones. Sound waves with strong vibrations break the kidney stones. It then goes out of your body when you urinate. This process takes up to 45-60 minutes. You will be under sedation during the procedure. ESWL can cause blood in the urine, bleeding around the kidney or bruising in the back or abdomen. 

Holmium laser lithotripsy

It is the latest form of treatment for kidney stones. This procedure uses lasers to remove stones in the kidneys, bladder, ureters or in the urethra.

RIRS (retrograde intrarenal surgery)

It is a safe procedure to remove stones in those people with a single kidney.

Preventing kidney stones

There are some steps that you can take to prevent the occurence of kidney stones.

• Drink lot of water - Your urine will then be light and clear, and you will be free of any symptoms of kidney stones. 
• Choose a low diet in salt and animal protein - Have a diet with minimal salt and animal protein. It will reduce your risk of kidney stones. 
• Eat lesser oxalate-rich foods - These include beets, okra, spinach, rhubarb, nuts, tea, chocolate, and soy products