Latest News, Health and Wellness
- December 06, 2021
- By Grand Itasca
If you were to pour salt in a glass of water, it will dissolve, up to a certain point, where it can no longer dissolve. This is essentially what happens in your kidneys and when the salt can no longer dissolve, it can form a kidney stone.
Many patients with kidney stones may never know they have them. They will pass through their urine without any pain. If the stones become too large, they can obstruct the flow of urine, however, and cause significant discomfort. If the stone becomes large enough and moves into an unfavorable location blocking the urine stream, the urine will back up in the kidney and the kidney will stretch. This stretching is what causes the most pain. Patients tend to come to the emergency room with this level of pain. It is also possible to manage this pain with some over-the-counter medicines. Sometimes the stone can spontaneously pass but if it is too large and it does not pass, surgery may be needed to remove it.
Understanding the source of pain from a kidney stone is important to receiving an accurate diagnosis. Typically, if a patient comes to the emergency department with severe unexplained pain, suspected to be caused by a kidney stone, they will undergo a CT scan to determine the location and stone of the stone. This information helps determine if the stone is likely to pass on its own or need surgical intervention.
If the patient has a smaller stone that will likely pass on its own, they are likely able to return home and manage pain with over-the-counter medicines. If the stone is not likely to pass on its own, the patient is typically referred to a urologist. If there is an obstructing stone that has caused an infection, urgent management and a stent are typically required. The stent allows the urine to drain while the infection is treated with antibiotics. Once the infection is resolved, the kidney stone can then be treated.
If it is determined that surgery is necessary to remove a kidney stone, the urologist will likely perform on of three surgeries:
- Shockwave lithotripsy
- Percutaneous nephrolithotomy
All three approaches are different ways to provide energy to the kidney stone to break it up and remove it. The location and size of the stone determines the surgical selection. Most patients have ureteroscopy. Ureteroscopy a definitive way of removing the stone in one surgery. It is minimally invasive in that it does not require any incisions and it's done through the urinary tract.
Particularly for people who have had one or more kidney stones, it is important to consider what is causing the kidney stones and address the root cause. Primarily kidney stones can be prevented by fluid and diet management. By increasing fluid intake so urine output volume is at least two to two and a half liters every 24 hours, kidney stones have a significantly lower chance of developing. Also, a low salt diet supplemented with citrate (which is found in lemon and orange naturally) as well as maintaining a moderate protein intake diet can help as well.
If patients have continued issues with forming of stones, a workup can be done. This is essentially a collection of urine over the course of 24 hours. The workup allows the urine to be tested to see which salts are contained within the urine. Specific recommendations are then given based the presence of the various salts.