Conditions & Treatments

Kidney Stones Treatment Chattanooga, TN

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.

Medical Management

Because 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 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)

  1. 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 the morbidly obese.
  2. 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 use of a flexible ureteroscopy or rigid ureteroscope depending on 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 in to 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.
  3. 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.
  4. 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.
  5. 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 preventing 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.

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