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University Surgical Cluster

Common Conditions:

Benign Prostatic Hyperplasia (BPH)

Irritable Bowel Syndrome

Breast Surgery

Kidney Stones

Colon Cancer

Liposuction

Erectile Dysfunction

Prostate Cancer

Face Lift

Upper Gastrointestinal Surgery

Haemorrhoids/Piles

Urinary Incontinence

Kidney Stones

 

About the condition

Kidney stones are small, hard deposits of mineral and acid salts on the inner surfaces of your kidneys.

Causes of the condition

Kidney stones form when the components of urine (fluid and various minerals and acids) are out of balance. Problems in the way your system absorbs and eliminates calcium and other substances create the conditions for kidney stones to form. Less common causes include inherited metabolic disorder, kidney disease, gout, inflammatory bowel disease and some drugs.

It is common, however, for kidney stones to have no definite single cause. A number of factors, often in combination, create the conditions in which susceptible people develop kidney stones.



The following are some common types of stones:

  • Calcium stones
  • Struvite stones
  • Uric acid stones.
  • Cystine stones
 

Signs & symptoms

Signs and symptoms may include:

  • Pain in the side and back, below the ribs
  • Fluctuations in pain intensity, with periods of pain lasting 20 to 60 minutes
  • Pain waves radiating from the side and back to the lower abdomen and groin
  • Bloody, cloudy or foul-smelling urine
  • Pain on urination
  • Nausea and vomiting
  • Persistent urge to urinate
  • Fever and chills if an infection is present

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Diagnosis and treatment options

Many kidney stones go unnoticed until they cause acute symptoms, specifically, loin pain as the stone passes through the ureter. In many instances, the stones may be discovered incidentally.

If your doctor suspects you have kidney stones, he or she is likely to arrange for an imaging study. An abdominal X-ray can visualize most kidney stones and can help to judge changes in the size of a stone over time. You may also have one or more of the following imaging tests:

1. Computerized tomography (CT) scan
2. Ultrasound
3. Intravenous Pyelography (Excretory Urogram)


Different treatments are available for kidney stones, depending on the type of stone and the root cause. One simple way to move a stone through your urinary tract is to drink plenty of water to gush it out.


Stones that can't be treated with more-conservative procedures, either because they're too large to pass on their own or because they cause bleeding, kidney damage or on-going urinary tract infections that may need more invasive procedures. This includes:


1.    Extracorporeal shock wave lithotripsy (ESWL). A commonly used method to treat kidney stones is using shock waves to shatter the stones into tiny pieces which are then passed out from your urine. Usually it requires sedation or light anaesthesia because of the moderate pain caused by the shock waves.

 

Some complications that may occur with ESWL are:

  • Blood in the urine
  • Bruising on the back or abdomen
  • Bleeding around the kidney and other adjacent organs
  • Discomfort as the stone fragments pass through the urinary tract


At times, there may possibly be a need for a second round of ESWL or ureteroscopic stone removal as the stones may not shatter completely. After treatment, it may take months for all the stone fragments to pass.


2.    Percutaneous nephrolithotomy. When ESWL is not effective or the kidney stone are too big, the stone could be eliminated through a small incision in your back using an instrument called a nephroscope.

3.    Ureteroscopic stone removal. This procedure may be used to remove a stone lodged in a ureter. The stone is entrapped with a small instrument (ureteroscope) and later passed into the ureter through your bladder. Ultrasound or laser energy can also be directed through the scope to smash the stone. These techniques work particularly well on stones in the lower part of the ureter.

 

 

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