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In human ‘Kidney’, urine is separated from blood, in the process of kidney’s function of purifying blood under circulation. From urine some crystals get separated to form a hard substance, which is called “Kidney Stone”. Kidney stones will be of various combinations of various chemicals, normally,
- Calcium combined with
- Oxalate or
which are part of your food and parts of your body such as bones and muscles.
Types of Kidney Stones caused by Infection in the urinary tract are: –
- Straiten or Infection stone
- Uric acid stones
- Sistine stones
Human urine contains some chemicals which prevent or inhibit the crystals formation. These inhibitors will not work for some people. The causes for Kidney Stone formation are:-
- Not drinking enough water: To prevent cystine stones, you must drink enough water each day to dilute the concentration of cystine that escapes into the urine. More than a gallon of water will be needed every 24 hours, and a third of that must be drunk during the night.
- Diet Choices/Dairy Products: In the past, people who form calcium stones were advised to avoid dairy products and other foods with high calcium content. Recent studies have shown that foods high in calcium, including dairy products, will help to prevent calcium stones. However, taking calcium in pill-form will increase the risk of developing kidney stones. Kidney stone patients must avoid food with added vitamin D and certain types of antacids that have a calcium base. People who have highly acidic urine must eat less meat, fish, and poultry which will increase the amount of acid in urine.
- Family History/Hereditary: A disease called “Renal Tubular Acidosis”, which is hereditary is seen to develop kidney stones
- Taking food and drink containing Oxalates
The symptoms of Kidney Stone are: –
- Unbearable /Extreme Cramping Pain in the Lower Back and /or Side, Groin, Abdomen: If the stone is too large to pass out, pain will continue as the muscles in the wall of the narrow urethra try to squeeze the stone into the bladder. As the stone moves and the body tries to push it out, blood may appear in the urine, making the urine pink. As the stone moves down the urethra, closer to the bladder, the person may feel the need to urinate more often or feel a burning sensation during urination.
- Trace of Blood in urine
- Nausea and Vomiting
- If fever and chills accompany any of the above symptoms, an infection may be present. In this case, a doctor must be contacted immediately.
The doctor will decide to scan the urinary system using a special test called a Computerized Tomography (CT) scan or an IntraVenous Pyelogram (IVP). The results of these tests will help to determine the appropriate treatment. A Helical CT Scan without contrast material is used for diagnosing Kidney Stone and obstructions in the Urinal Tract.
Sometimes “silent” stones, which do not cause symptoms are found on X- rays taken during a general health examinations. Normally, the kidney stones will pass out through urine in the normal course within 48 hours without pain. If the stones are small, they will often pass out of the body unnoticed. Also kidney stones are found on X- rays or ultrasounds taken of people who complain of blood in the urine or sudden pain in the lower stomach. The diagnostic images from the Scans and X rays will give the doctor valuable information about the stone’s size and location.
For the Kidney Stones that do not pass out through urination, a Shock Wave Procedure named “Lithography” is used for breaking the large kidney stones into smaller pieces to enable them to pass out through urine.
Blood and urine tests will help to detect any abnormal substance that might promote stone formation. Urine Test on urine collected for a continuous 24 hours will be used to measure urine volume and levels of acidity, calcium, sodium, uric acid, oxalate, citrate, and cretonne, a product of muscle metabolism. The results will be helpful in determining the cause of the stone. After the medication, a second 24-hour urine collection will have to be done to determine whether the treatment is working.
Normally,surgery need not be done for removal of Kidney stones as the stones can be broken into pieces for passing out in urine, by medications and drinking water and fluids and taking in painkiller tablets, wherever necessary. The passed out stones will have to be collected for laboratory tests for assessment.
Surgery will be necessary to remove Kidney Stone in the following cases:-
- If the stone does not pass out in urine after a reasonable period of time and causes constant pain
- If the stone is too large to pass on its own or is got stuck up in the urinary tract.
- If the stone blocks the flow out of urine
- If the stone causes an ongoing urinary tract infection
- If the stone damages kidney tissue or causes constant bleeding
- If the stone has grown larger, as seen on Scans and X- rays
Types of Kidney Stone Removal Surgery:-
Some thirty years ago, an open surgery was necessary to remove Kidney stones which required a recovery time of 4 to 6 weeks. The treatment for removal of Kidney stones has been made easy today, and had improved a lot, and surgery do not require major/open surgery and the surgery can be performed easily.
Extracorporeal Shock Wave Lithotripsy (ESWL) is the procedure used for the treatment of kidney stones. In ESWL, shock waves that are created outside the body travel through the skin and body tissues until they hit the denser stones. The stones break down into small particles and are easily passed through the urinary tract in urine.
Several types of ESWL devices are available and the surgeons use either X rays or Ultrasound to for pinpointing the stone during the treatment. For most types of ESWL procedures, anesthesia is needed. In many cases, ESWL can be done on an Out-Patient(OP) basis. Recovery time is shorter than the traditional surgery and the patients can resume normal activities within a few days.
However, complications may be there with ESWL in some patients who will have blood in their urine for a few days after the treatment. Bruising and minor discomfort in the back or abdomen from the shock waves can occur. To reduce the risk of complications, doctors will advise the patients to avoid taking in Aspirin and other medicines that affect blood clotting for several weeks before the surgery for removal of kidney stones.
In some cases, the shattered stone particles will cause blockage as they pass through the urinary tract and cause discomfort. In those cases, the doctor will insert a small tube/ stent through the bladder into the ureter to help the fragments pass. Sometimes the stone/s will not be completely shattered with one treatment, and additional treatments will be necessary.
If the stone is very large in size, a procedure called “Percutaneous Nephrolithotomy” is used to remove kidney stone. In this procedure, the surgeon will make a tiny incision in the back and create a tunnel directly into the kidney. Using an instrument called a nephroscope, the surgeon will locate and remove the stone. For large stones, some type of energy probe, ultrasonic or electrohydraulic will be necessary to break the stone into small pieces. The patients will have to stay in the hospital for several days and will have a small tube called a ‘nephrostomy’ tube left in the kidney during the healing process. The advantage of percutaneous nephrolithotomy is that the surgeon can remove some of the stone fragments directly instead of relying solely on their natural passage from the kidney.
To prevent formation of Kidney Stones, drink enough water and fluids.
‘Kidney Stones’ are different from “Gall Stones”