Stones
Kidney stones are formed when certain substances in blood which are excreted in urine (such as calcium, oxalate, and uric acid) crystallise. These minerals and salts form crystals, which can then join together and form a kidney stone.
Kidney stones usually form within the kidney, where urine collects before flowing into the ureter, the tube that leads to the bladder. Small kidney stones are able to pass out of the body in the urine and may go completely unnoticed. But larger stones irritate and stretch the ureter as they move toward the bladder, blocking the flow of urine and causing excruciating pain. Rarely, a stone can be too large to pass into the ureter and remains lodged in the kidney, but may still require treatment.
Why some people form kidney stones and others don’t is not always clear. Kidney stone disease is more common in young and middle-aged adults than in the elderly, and more prevalent in men than women. People living in hot climates are sometimes prone to kidney stones because they may be slightly dehydrated, which concentrates the minerals in their urine and makes crystal formation easier. Medical evidence suggests that drinking too few fluids can exacerbate this chemical oversaturation of the urine.
Sometimes indulgence in a particular food type such as green leafy vegetables, chocolates, seafood etc can lead to stone formation. It is well understood that not everyone with these risk factors will develop kidney stones. There are certain intrinsic factors which play a major role in initiation of stone formation.
There are various treatment options available to manage kidney stones.
Expectant treatment involves hydration and pain relief. This treatment is offered to patients who have small sized uncomplicated stones.
Noninvasive Treatment
ESWL (Extracorporeal Shock Wave Lithotripsy)
This treatment involves targeting “shock waves” on kidney stones from external body surfaces. There are various factors which could be responsible for the final outcome of this treatment. Not all types of stones can be treated with this treatment.
Minimally Invasive Methods
Ureterorenoscopy
A rigid ureteroscope is commonly used to retrieve ureteric stones. Generally such stones need to be fragmented by laser or by lithoclast (miniature “Jack Hammer”) before they are retrieved using a basket.
A flexible ureterorenoscope has an ability to flex its tip in either direction. Because of its versatility, this telescope could access any internal area of kidney so as to treat complex renal stones.
PCNL (Percutaneous Nephrolithotomy)
See the separate section on PCNL.
Open Procedures
Ureterolithotomy or Nephrolithotomy procedures involve exposing part of the ureter or kidney respectively to remove urinary stones. These procedures typically involve longer recuperation period. Due to advancing urological technology, indications of these procedures have been very limited.
