Kidney stone is one of the most painful medical conditions for humans. Kidney stones as the name suggests, usually originate in the kidneys. However, stones can develop anywhere along the urinary tract, which consists of these parts:
Kidney stones vary in size; can be as small as a grain or as large as a pearl. A kidney stone of any size if stuck in the urinary tract, block urine from getting through.
Kidney stones are formed when urine has high levels of certain minerals like Calcium, Oxalate, Uric Acid.
However, other risk factors make one more likely to get kidney stones. These include:
If the patient is suspected to be carrying a kidney stone, he or she is advised to take up the following tests:
One experiences signs and symptoms when the stone can move around within the kidney, or into the tube that connects the kidney to urinary bladder.
Following investigations are used as diagnostic tools to rule out the presence of kidney stones.
Several treatment options for kidney stone removal are discussed below:
There are prescription medications that relax the walls of the ureter and widen the passage so that body pass a kidney stone. Medicines are helpful in very small size stones. Medications are beneficial to get rid of any infection in urine. Also for pain relief, medications are recommended.
ESWL or Extracorporeal Shock Wave Lithotripsy is a procedure in which high-energy shock waves are passed through the kidney(similar to a normal X-ray procedure) to break a kidney stone into little pieces. The small pieces then pass out through the urinary tract more easily over a few weeks.
This procedure takes about an hour, and patient can go home about an hour later. This does not involve any surgical cut or incision. But ESWL does not work well on stones with size more than 8mm.
Kidney stones if cause repeated infections in the urine or pain or they are blocking the flow of urine from the kidney,then surgical options are recommended to remove stones in the kidneys or ureters.
Ureterescopy is done when the stone has moved from the kidney and is close to the bladder. In this procedure, a small telescope called Ureteroscope is made to pass into the bladder, up the ureter and into the kidney and stone is removed using a small cage. A camera is attached with Ureterscope.
URS is carried out in General Anaesthesia. No cut is made in this procedure as the scope is passed through Urethra.
In this procedure, patient can be discharged to home on the very same day and can start normal activities after 2-3 days.
Percutaneous Lithotripsy is the gold standard treatment for large kidney stones. PCNL is performed under general anaesthesia. In PCNL, a rigid telescope called “Nephroscope” is passed into the hollow center part of the kidney where the stone is located making a small incision (cut) in the back or side.
An instrument passed through the nephroscope suctions out the stones after breaking into pieces. Hospital stay is of 1 day in PCNL. Patient can start normal activities after 1 week.
RIRS is an advanced procedure for doing surgery within the kidney to remove the stones. It is considered to be the best mode of treatment till date. In this procedure, the flexible scope is passed through the urinary opening into the bladder and then the scope is moved up to the urinary tract system (retrograde) to within the kidney (intrarenal). RIRS is performed by a urologist who is expert in performing RIRS. It is done under general or spinal anaesthesia. No cut is involved in this procedure.
Patient can go home after a day of procedure and start daily routine within a week.
RIRS offers a quicker solution of the problem, minimal pain after surgery, and much faster recovery.
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To know more, Read other Kidney Stone Blog.