Anyone who has ever passed kidney stones will probably tell you that they caused some of the most excruciating pain they have ever experienced. You wouldnt think something as small as 5mm could cause so much trouble, but the pain and ordeal of kidney stones are among the leading causes for emergency room visits and hospital admissions.
Fortunately, the urologists at Henry Ford can diagnose and treat stones quickly and effectively, as well as help you prevent them from recurring.
To help give you a better understanding of what kidney stones are and how they can be treated, our urologists have put together these questions and answers.
What are kidney stones?
First off, there is no relationship between kidney and gall bladder stones. Your kidneys are responsible for filtering your blood and removing substances and chemicals from your body through its urine. Kidney stones are abnormal formations of mineral deposits caused by various reasons. The stones start out in the kidneys calyx (a small, cup-shaped portion of the kidneys urinary collection area). They may stay there and grow, or they eventually start to pass. They may pass naturally or they may become blocked along the way in the kidney pelvis or in the ureter (the narrow tube that carries urine from the kidney to the bladder).
What causes kidney stones?
There is usually an abnormality in a persons metabolism that is associated with stones, and there are a number of factors that can contribute to them: lack of water (dehydration), high calcium diets, foods that are high oxalate (cola, chocolate, spinach, peanuts, tea), kidney infections, gout, urine blockage, hot climates or hereditary conditions.
Who gets kidney stones?
Kidney stones affect as many as 10 percent of people in the United States at some point in their lifetime. Both men and women are susceptible, but kidney stones are more common in men and usually occur over the age of 30.
What are the symptoms?
It is possible for a person to pass a kidney stone without any pain. However, most of the time kidneys stones are passed with severe, stabbing pain that usually starts in the back on one side and travels in waves. The pain can last for hours or days and can be accompanied by nausea, fever and blood in the urine.
Most kidney stones pass on their own, usually within a couple of days after the onset of pain. However, a stone with a diameter more than 5mm is probably too large to pass, and will require surgical treatment.
What are the different types of kidney stones?
Calcium Oxalate and Phosphate - These are the most common types of stones. They are made up of a hard salt compound that can be caused by a high oxalate diet, inflammatory bowel disease, a calcium disorder or various other reasons.
Uric Acid - This type of stone is caused by too much uric acid in the urine. It is often found in patients with gout and/or rich diets. It may be treated by alkalinizing the urine with medications, increasing urine output and improving the diet.
Struvite (infection) - This stone, made of calcium magnesium, ammonia and phosphate, is caused by urinary tract infections. Since this type of stone can carry bacteria and contribute to recurring infections, it needs to be removed. However, first the infection needs to be treated with antibiotics.
Cystine - This is a rare (less than one percent of all stones), inherited type of stone disease that is caused by too much cystine (an amino acid) in the urine. It is best treated by complete removal and possibly dissolution, and can be prevented with medications and by reducing methionine (usually found in fish) from the diet.
Mixed - These are a combination of any of the above stones.
What types of treatments are offered for kidney stones?
Depending on the type and location of the stones, the urologists at Henry Ford offer several options for treatment.
Expectant Therapy - Since most stones are usually small enough, a urologist may recommend waiting to see if they pass on their own. To help the process along, the patient will need to drink plenty of water and then urinate through a strainer to catch any stones for the doctor to analyze. Once the doctor determines the type of stone, he can make further recommendations for treatment and prevention.
Medications - Depending on the type, some medications are effective for dissolving the stones.
Extracorporeal Lithotripsy - Lithotripsy is a standard treatment for most kidney stones that do not pass on their own. It is a painless, non-invasive, outpatient procedure that uses shock waves from an energy source to break apart the stones.
Ureteroscopy - Sometimes a stone gets trapped in the ureter. This procedure involves passing a ureteroscope into the bladder and up the ureter to see the stone. If the stone is not impacted, it is extracted. If its too large or impacted, then it can be broken apart with a laser, electrohydrolic, ultrasound or mechanical impaction device.
Percutaneous Lithotripsy - This procedure is used to remove large stones (one inch diameter and larger). Its an invasive operation that requires making a small incision on the side of the body and inserting an instrument into the kidney to break apart the stone with shock waves. The stone pieces are then snared or sucked out. A nephrostomy tube (a tube in a persons side that drains urine directly from the kidney) is left in for several days. The procedure usually requires a 3-5 day hospital stay.
How can stones be prevented?
Following proper diagnosis, treatment and recommendations by a urologist, a patient may prevent stones by:
Drinking plenty of water
Avoiding dehydrating liquids (alcohol, caffeine)
Following a prescribed diet
Taking medications (if prescribed)
Following up with the doctor.
Where else can stones form?
Stones may also form in the bladder. These stones are usually larger than kidney stones. They may be too large to pass through the urethra and become lodged in the bladder. Symptoms include a frequent urge to urinate, pain during urination and possibly blood in urine.
These stones may also pass on their own. If not, a urologist may need to remove them -- either through surgery or a procedure that uses a cystoscope inserted through the urethra into the bladder to pull out or crush the stones.
