Kidney stones (or renal calculi) are nothing but mineral deposits that form in the kidney and either stay there or get lodged along the urinary excretory system pathway. The problem with kidney stones is that they often get stuck and block the flow of urine, possibly causing severe pain and blood in the urine. The kidney’s chief function is to filter the salts and minerals in the blood and produce the main excretory liquid by-product of the body- urine. Stones form when crystals coalesce. People who drink less water have higher chances of developing kidney stones due to dehydration. Drinking 2 to 3 litres of water each day is highly recommended to prevent kidney stones.
When is a kidney stone removal indicated?
When the kidney stone is symptomatic or can possibly cause symptoms or blockages, they must be removed.
The classic kidney stone symptoms are flank (sides of the abdomen) or back pain, nausea and vomiting, blood in the urine and frequent urination.
The diagnosis of a kidney stone can be made by symptoms alone. The urologist will most likely confirm the kidney stone by investigating kidney function (creatinine), check the urine for blood, and order either a CT scan or X-ray to see size and location of stone. Once the diagnosis is made, a decision to treat the stone or let it pass by itself will be made based on the stone’s size, location and your symptoms.
What is the procedure for kidney stone removal?
- Medical Treatment: Conservative treatment may be undertaken if the stone is not blocking the kidney and symptoms are minimal. The most important medicines are water, time and painkillers. A follow-up CT or X-ray will show if any progress has been made.
- Surgical Treatment:
- A) ESWL (Extra-Corporeal Shock Wave Lithotripsy): This a minimally invasive treatment typically performed as an outpatient. The stone is viewed on X-ray and shocked even upto 3000 times over about a half-hour session.
- B) Ureteroscopy with Lasertripsy: If the stone is lodged further down in the ureter or the ESWL was ineffective, this procedure is recommended. A thin fiber-optic scope is guided directly to the stone and then a laser fiber is used to fracture the stone. A stent is usually placed in the ureter subsequently and will be removed in one week in the office.
- C) Percutaneous Nephrostolithotomy (PCNL): This is a major but closed operation requiring admission to the hospital. This approach is best for large stones measuring more than 2 cm. A minute tube is placed directly within the kidney to guide removal of large stones.
- D) Open Surgery: This is recommended only if there is maximal kidney damage or other anatomic abnormalities of the kidney.