Kidney stones occur when substances that are normally dissolved in the urine begin to crystallize inside the body. Once stones have begun to form, they become larger as new crystalline deposits layer around the original kidney stone.
Kidney stones frequently move through the urinary tract and can cause irritation and blockages. Symptoms including pain, fever, nausea, and blood in the urine may occur as a result. Depending on the location, composition, and size of the stones, they can even cause serious damage to the kidneys.
Stones are often caused by not drinking enough water, though you may also have other issues with your diet or metabolism that need to be addressed. Kidney stones run in families and often come back over and over, so it is important to try to prevent stones from forming before you have pain or need surgery.
Even after kidney stones have been successfully treated, patients who have had them are greater than 50% more likely to experience them again than someone who has never had kidney stones. Fortunately, medications and dietary changes can significantly reduce your chances of a recurrence.
Small Kidney Stones
This minimally-invasive technology breaks up kidney stones using focused ultrasound waves completely from the outside of your body. ESWL is easier to perform for stones that are visible on plain x-rays because this type of x-ray is used to target the stones during treatment. ESWL may be associated with less discomfort than other treatment options such as ureteroscopy or percutaneous nephrolithotripsy. However, ESWL does not usually have as high of a success rate as these other surgical treatment options and is more likely to require re-treatments.
Ureteroscopy involves the use of a small, flexible or rigid device called a ureteroscope to directly see and treat stones. The ureteroscope device, which provides a video image, is inserted into the bladder and up the ureter until the stone is encountered. The stone can then either be broken up with a laser fiber or pulled out using small baskets that are inserted into the working channels. The advantage of this type of surgery is that the body’s normal openings are used and no incisions are necessary. A stent will be placed into the ureter once the stone is removed to prevent the swelling process from interfering with urine flow. The stent is usually pulled by the patient at home about 5 days after the procedure.
Percutaneous stone surgery is usually used for larger stones. A small hollow tube is placed directly through a patient’s back into the kidney through which larger instruments can then be used to fragment and extract the stone(s). Although this approach typically requires a hospital stay and is more invasive than ureteroscopy or extracorporeal shockwave lithotripsy, it is often the most effective method for treating larger stones quickly and completely. Percutaneous stone surgery may also be indicated in certain situations where the ureter below a kidney is obstructed, such as in ureteropelvic junction obstructions, where the ureteroscope cannot be advanced from below.