Kidney Stones and Your Treatment Options

Kidney stones are a relatively common problem, affecting approximately two in 20 women and three in 20 men. They are solid material, consisting of salts and minerals which form into hard crystals. They can be small enough to simply pass through body through the urinary system undetected, without causing pain. However, some kidney stones become large enough to causes blockages, which occur in the ureter (the tube connecting the kidney to the bladder) and the urethra (the tube through which urine passes to leave the body).

Typically, the first symptom of kidney stones is cramping and pain, which is often severe and develops very quickly. Fortunately, there are good, established treatment options, depending upon the size and location of your stones.

What are the causes of kidney stones?

The kidneys have an important role in the body to clean the blood by filtering out waste products and water to make urine. Kidney stones can develop if there is a build-up of minerals or salts, your body struggles to break them down and they form crystals.

• Dehydration is one of the most widely recognised causes of kidney stones. You should drink six to eight glasses of fluid each day, ideally water or clear fluids. Coffee and tea can contribute to the problem
• A high level of red meat consumption is a risk factor, together with chocolate and peanuts (foods containing oxolates). Although some people can eat these foods without developing kidney stones, if you have a predisposition to this problem, dietary changes can be very helpful
• Urinary tract infections increase your risk of this problem
• There may be an increased risk due to lack of exercise

Kidney Stone Treatment options

 Lithotripsy

This is the most minimally invasive approach to treatment but is only appropriate for people who have small to medium sized stones. Known medically as Extracorporeal Shockwave Lithotripsy (ESWL), it involves breaking up the deposits using high energy shock waves. Once broken into fragments, they can be passed out of the body in the urine, thus avoiding any surgery or incisions.

Ureterorenoscopy

This is the next level approach which may be used if a stone is more than 1cm in diameter, if it is located in the lower part of the kidney or if lithotripsy has been used and has not been successful. A thin telescope containing a laser is passed up through the bladder and urethra to the kidney to precisely target the stone and break it up.

Percutaneous nephrolithotomy (PCNL)

This is the approach used for stones that are large, difficult to reach, or very hard and unresponsive to other treatments. It is a form of keyhole surgery, making a small incision in the lower back in order to reach and break up the stone.

Metabolic tests and ongoing prevention

Unfortunately, if you have one occurrence, your chance of developing the same problem are increased. Therefore, it is very important to:

• Have metabolic investigations to establish what type of stones you have developed; this will inform an ongoing prevention strategy
• Your urologist needs to work with you to develop an prevention strategy, encompassing fluid intake, diet and any other factors which may help you reduce the risk of the same problem reoccurring.