Kidney Stones – Types, Symptoms & Treatment from Best Hospitals & Top Surgeons in India
Hardened mineral deposits formed in the kidney are called kidney stones (calculi). These originate as microscopic particles and over the course of time develop into stones. Medically this condition is known as nephrolithiasis or renal stone disease. The kidneys filter waste products from the blood and add them to the urine.
When waste materials in the urine do not dissolve completely and the kidney is unable to evacuate them, crystals and kidney stones are likely to form. Some stones may pass out of the kidney or get lodged in the ureter (tube that carries urine from the kidney to the bladder) and cause severe pain that starts from the low back and radiates to the side or groin.
A lodged stone can block the flow of urine and build a backpressure in the affected ureter and kidney. Increased pressure results in stretching and spasm causing severe pain in the lower back.
There are different types of kidney stones. The exact cause depends on the type of stone. Stones can form when urine contains too much of certain substances. These substances can create small crystals that become stones. The stones take weeks or months to form.
Calcium Stones: Calcium Stones are most common. They are more common in men between the ages 20 – 30 years. Calcium can combine with other substances, such as oxalate (the most common substance), phosphate, or carbonate, to form the stone. Oxalate is present in certain foods such as spinach. It’s also found in vitamin C supplements. Diseases of the small intestine increase your risk of these stones.
Cystine Stones: Cystine Stones consist of cystine, one of the protein building blocks that make up muscles, nerves, and other parts of the body, can build up in the urine and form a stone. Cystine stones are rare. The disease that causes cystine stones (cystinosis) runs in families.
Struvite Stones: Struvite stones are mostly found in women who have a urinary tract infection. These stones can grow very large and can block the kidney, ureter, or bladder. Struvite stones tend to form when the pH of the urine is abnormally high or alkaline due to breakdown of urea into ammonia salts by the infecting bacteria.
Uric Acid Stones: Uric acid stones may form when there is too much uric acid in the urine. It is the most common cause of radiolucent kidney stones in children. Several products of purine (amino acid) metabolism are relatively insoluble and can precipitate when urinary pH is low.
Small and smooth kidney stones may remain in the kidney or pass without causing pain (called “silent” stones). Stones that lodge in the ureter (tube that carries urine from the kidneys to the bladder) cause the urinary system to spasm and produce pain. The pain is unrelated to the size of the stone. Other symptoms of kidney stones may include the following:
Blood in the Urine.
Increased Frequency of Urination.
Nausea and Vomiting.
Pain and Burning during Urination.
Fever, Chills, Loss of Appetite.
Urinary Tract Infection.
Diagnosis of Kidney Stones
In addition to a complete medical history and physical examination, diagnostic procedures for kidney stones may include the following:
Intravenous Pyelogram (IVP) :A series of x-rays of the kidney, ureters, and bladder with the injection of a contrast dye into the vein – to detect tumors, abnormalities, kidney stones, or any obstructions, and to assess renal blood flow.
Urinalysis : Laboratory examination of urine for various cells and chemicals, such as red blood cells, white blood cells, infection, or excessive protein.
Blood Tests : Laboratory examination of the blood to detect substances that might promote stone formation.
Renal Ultrasound : A non-invasive test in which a transducer is passed over the kidney producing sound waves which bounce off the kidney, transmitting a picture of the organ on a video screen. The test is used to determine the size and shape of the kidney, and to detect a mass, kidney stone, cyst, or other obstruction in the kidney.
Extracorporeal Shock Wave Lithotrispy (ESWL): Extracorporeal shockwave lithotripsy (ESWL) is a procedure used to break down kidney stones.Kidney stones are small, solid masses that form when salts or minerals normally found in urine become solid crystals inside the kidney. Usually, the crystals are very small and pass harmlessly out of your body. But if they build up inside your kidney, they can cause pain, infection and damage your kidney function.
Sometimes, smaller kidney stones move out of the kidneys into the tubes that carry urine from your kidneys to the bladder (ureters). These small stones can cause severe pain if they rub against or get stuck in your ureters.
Percutaneous Nephrostolithotomy (PCNL): Percutaneous Nephrolithotomy, or PCNL, is a procedure for removing medium-sized or larger kidney stones from the patient’s urinary tract by means of a nephroscope passed into the kidney through a track created in the patient’s back. This procedure uses an ultrasonic or laser probe to break up large kidney stones and suction it out. This procedure is usually done under general anesthesia or spinal anesthesia. In percutaneous nephrolithotomy or nephrolithotripsy, the surgeon makes a small incision in your back to remove kidney stones. He or she then puts a hollow tube into your kidney and a probe through the tube.
In nephrolithotomy, the surgeon removes the stone through the tube. In nephrolithotripsy, he or she breaks the stone up and then removes the fragments of the stone through the tube. The purpose of PCNL is the removal of renal calculi in order to relieve pain, bleeding into or obstruction of the urinary tract, and/or urinary tract infections resulting from blockages.
Percutaneous Nephrostolithotomy (PCNL)Ureteroscopic Lithotrispy with Holmium Laser: This procedure is performed under Epidural and Spinal Anesthesia to treat stones located in the middle and lower ureter. A small, fiberoptic instrument (ureteroscope) is passed into the ureter. Large stones are fragmented using 100-Watts Coherent Holmium Laser. The laser fragments stone into sand like particles, which are then flushed out through the natural urinary passage.
The advantage of Holmium Laser is its ability to fragment stones of all compositions and precision. Thus, it is the most effective laser for the treatment of ureteric stones. Patients are generally admitted on the same day of the treatment and are discharged next day, which means only 24 hours hospitalization.
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