KIDNEY STONES
DR. DHEERAJ SHAMSUKHA MBBS, MS, MCH. UROLOGY
KIDNEY STONE SIGNS AND SYMPTOMS
Kidney stones are conglomerations of crystals that form when concentrations of minerals in the urine become very high. Stones almost always start in the kidneys. They may cause problems there, or may not be noticed until they move into the ureter (the tube that connects the kidney to the urinary bladder). Once stones enter into the ureter it can obstruct the drainage of urine which generally causes symptoms such as pain in the upper back (i.e., the flank) or lower abdomen, nausea, vomiting, and blood in the urine. Many stones will pass down the ureter, into the bladder and then be voided with urine. Occasionally stones can remain lodged in the ureter or within the bladder.
KIDNEY STONE TREATMENT OPTIONS
Our Urologist Dr. Dheeraj Shamsukha works with patients in every stage of their condition, creating a personalized plan whether surgery is needed or not. He also tries to identify factors that may be causing the stones, so as to keep current stones from getting larger and reduce the risk of developing future stones.
When suspected of having a kidney stone, a history is taken, physical exam is performed, and radiological imaging is obtained. Study may include a plain x-ray of the abdomen, a renal ultrasound, or a CT scan. They help in determine the location of the stone, its size, the degree to which the stone may be causing an obstruction to urine flow, and what types of therapy would be appropriate for management.
CONSERVATIVE MANAGEMENT
In cases when the stone has moved into the ureter, especially if the stone is small (less than 0.5 centimeters), often recommended is conservative management. Many smaller stones will pass on their own, allowing patients to avoid surgery. Conservative management includes pain control (usually with acetaminophen and a non-steroidal anti-inflammatory drug like ibuprofen), hydration (6 to 8 glasses of water a day), and medical expulsive therapy using an alpha blocker (e.g., tamsulosin). Many stones will pass with this management, without requiring a surgical procedure.
MINIMALLY INVASIVE SURGICAL TREATMENTS
Factors that influence stone passage include the stone’s size and location. The larger a stone is, the less likely that it will pass without surgery. Surgical treatment is usually recommended for stones 0.5 centimeters in size and larger, as well as for patients who fail conservative management. The procedures used today to remove stones are minimally invasive and highly effective. The most common techniques include shock wave lithotripsy, ureteroscopy with laser lithotripsy, and percutaneous nephrolithotomy. Our endourology team performs over a thousand of these procedures every year, using the latest technology.