Kidney Stones Treatment Chattanooga, TN
What are kidney stones?
Kidney stones are hard deposits made of minerals and salts that form inside the kidneys. Often made of calcium and uric acid these “stones” develop inside the kidneys, but then they can travel to other parts of the urinary tract.
About 1 out of every 11 people in the U.S. will get a kidney stone. They are more common in men, obese people, and diabetics.
What are the symptoms if you have a kidney stone?
A small kidney stone and stones that don’t move may not cause symptoms. But once the stone moves around within your kidney or passes into your ureter (the tube connecting the kidney and bladder), you will know. This can be very painful. Here are the symptoms that you will experience at this point:
- Severe pain in the side and back, below the ribs
- Pain that radiates to the lower abdomen and groin
- Pain that comes in waves and fluctuates in intensity
- Pain when urinating
- Pink, red, or brown urine
- Cloudy or foul-smelling urine
- Nausea and vomiting
- Persistent need to urinate
- Urinating more often than usual
- Fever and chills if there is an infection
- Urinating only in small amounts
What causes kidney stones to form?
Kidney stones form when your urine contains more crystal-forming substances — such as calcium, oxalate, and uric acid — than the fluid can dilute. The makeup of the person’s urine may not have sufficient substances to prevent crystals from sticking together. This makes it easier for kidney stones to form.
The cause of a kidney stone can often be traced back to the type of stone. For instance, if you a high-protein diet or have gout, that’s the likely cause of uric acid stones. If you’ve had a urinary tract infection, that’s likely behind your struvite stones. Certain dietary factors can cause calcium and oxalate to increase and cause a calcium stone to develop.
Do all kidney stones require removal?
Most small kidney stones don’t require removal. Drinking 2 to 3 quarts of water a day can flush out your urinary system and pass the stone. Over-the-counter pain relievers will help. If necessary, Dr. Shridharani can prescribe an alpha-blocker that relaxes muscles in your ureter to help pass the stone more quickly and with less pain.
What can happen if a kidney stone isn’t treated?
If a kidney stone doesn’t pass on its own, it will need to be addressed. As mentioned above, small stones can be passed without too much pain when you urinate. But once a stone has developed it’s likely to get larger and then the pain will increase and intervention will be necessary to break up the stone.
Kidney Stones Treatment Options
Many treatment options for stones are available. Symptoms, size of the stone, stone location in the urinary tract and type of stone will determine the type of treatment. If the stone is large, causes untreatable pain or dehydration, blocks the flow of urine, or accompanies an infection a procedure may be necessary.
How are kidney stones treated?
Most small kidney stones will pass out of your body through the urinary tract, with increased fluid intake and pain medications. To help stones pass without a procedure, medications such as tamsulosin (Flomax) may be given to help passage.
Because the stone disease may be linked to other health conditions, your urologist will perform a detailed medical and dietary history, test your urine, blood, and obtain imaging studies. For people with complicated stones or recurrent stone formers, a metabolic evaluation consisting of a comprehensive blood and urine tests may be indicated.
The most common recommendation by your urologist will be to increase your water intake, as dehydration is a key risk factor for stone formation. Stones are linked to diet, therefore your urologist will let you know what dietary changes can reduce your risk of forming stones. Medications such as potassium citrate or diuretics may be used depending on the type of stone you form.
Procedural options (performed while you are under an anesthetic)
- Shock Wave Lithotripsy (SWL) uses high energy sound waves to fragment the stones into small sand-like particles which can then be more easily passed. This is one of the most common treatments for kidney stones. It is best for kidney stones smaller than 2 cm, stones that are not overly dense, and those that can be seen on x-ray. The main attraction of lithotripsy is noninvasive and is performed on an outpatient basis. Furthermore, this procedure may allow you to have stone treatment without a need for a ureteral stent, which can cause some minor discomfort and urinary symptoms. Sometimes you may require more than one lithotripsy to completely treat your stones, the smaller and less dense the stone is the more likely you will need one treatment. This procedure is not recommended for pregnant women, people with bleeding disorders, infections, skeletal abnormalities or morbidly obese.
- Ureteroscopy with Laser Lithotripsy is an endoscopic option to treat stones located anywhere in the urinary tract. Stones up to 2 cm in diameter may be treated effectively. These stones can be treated with the use of a flexible ureteroscopy or rigid ureteroscope depending on the stone position within the urinary tract. A small miniature fiberoptic camera (ureteroscope) is inserted in the urethra and up into the kidney over a guidewire. A laser is then used to break the stones into small fragments. These fragments are extracted by the ureteroscope with a small basket or flushed out with water. It is an outpatient procedure usually performed under general or spinal anesthesia. Because the ureter swells from the stone and during the surgery, a small stent (hollow tube) may be placed in the kidney to facilitate urine flow postoperatively. The stent is removed at home if strings are left on the stent or subsequently at a follow-up visit. This treatment option also offers the highest success rate to have your stone removed with one procedure.
- Percutaneous nephrolithotripsy is an endoscopic means of removing large stones. It requires a small, less than 2 cm incision in the back. The stones are broken up with ultrasound or laser treatment. A hollow tube is inserted. The crushed stone is removed through this tube. This procedure is used for large and irregularly shaped stones (usually larger than 1.5cm – about the size of a marble), for people with infections, for people who are not candidates for ureteroscopy and for those whose stones cannot be broken up by extracorporeal shock wave lithotripsy. This requires general anesthesia and highly specialized surgeons.
- Robotic Surgery using the da Vinci® Robotic Surgical System is minimally invasive, offers less pain, blood loss, scarring, and faster recovery. It is a specialized form of minimally invasive surgery using a robotic arm, a camera, a 3D imaging processor and remote control. It is very precise and is ideal for delicate urologic surgery. Stones removed by the robot are usually performed in conjunction with another robotic procedure.
- Open surgery is rare and may be needed if other methods fail. Surgery may be required where the stones are damaging kidney tissue, causing recurring urinary tract infections, blocking the flow of urine or are significantly large.
Can kidney stones be prevented?
It is most beneficial to increase your water intake and make changes in your diet. Drinking lemon juice may be helpful. Studies suggest that a healthy intake of dairy products reduces kidney stone formation, but the use of calcium supplements may increase the risk. A normal calcium diet is suggested. High salt and high sugar diets may be bad for kidney stones. Obesity is related to kidney stones. Sometimes medicines can be used to decrease the risk of developing new stones. If a stone has passed and can be analyzed in a lab, the lab can determine the type of stone so that specific prevention methods can be used.
Dr. Shridharani is an expert in diagnosing and treating kidney stones. He has performed over a thousand kidney stone procedures and will get you on the right track to prevent the stones from returning with medical therapy. He is a top-rated urologist in the Chattanooga, Tennessee, Alabama and Northern Georgia area. Please contact us with your concerns. We will listen, answer your questions, explain your condition and provide stellar services to address your specific needs.
Is shock wave therapy safe?
Shock wave lithotripsy is the most common treatment for kidney stones. This treatment has the advantage of treating kidney stones without an incision. For patients who are good candidates for this treatment, about half of the patients will be stone free within a month, up to 75 percent within three months. This procedure is considered to be very safe, but there are some risks. There is a chance of causing internal bleeding, and the procedure can damage your kidneys. Also, problems such as infection or kidney damage can develop when a stone fragment blocks the flow of urine out of your kidneys.
Is ureteroscopy with laser lithotripsy safe?
Often after the laser is used to break up the stone and the fragments are removed by the ureteroscope, a ureteral stent is left in the ureter. This ensures that the kidney drains urine well after surgery. This leads to the main risk of this procedure. About half of patients have what is known as “stent pain.” The stent can rub on the inside of the bladder, causing a feeling of needing to urinate/overactive bladder. The stent can also allow urine to pass up from the bladder to the kidney during urination, causing symptoms from a warm, tingling sensation to intense pain. Also, the procedure can damage the ureter with a perforation. These will usually heal with stenting.