Kidney stone patients state that kidney stone pain is unforgettable, even more painful than childbirth, according to most women. Fortunately, the treatment options that are available today allow most kidney stones to be removed with incisions, as an outpatient.

Symptoms
The most common symptom of kidney stones is severe low back pain which radiates across to the front towards the groin area. Other accompanying symptoms include nausea, vomiting, and blood in the urine.

X-Ray Testing
In order to prove the presence of a kidney stone, an x-ray test of your urinary tract must be obtained. These tests may include a plan x-ray film of your abdomen or an IVP (intravenous pyelogram). An IVP involves injecting a kidney dye into your veins, and then x-rays are obtained as the kidneys excrete the dye in the urine. Other x-rays may include a CT scan of your abdomen and pelvis, or an ultrasound.

Treatment Options
The treatment for a kidney stone is dependent on its size and location. Naturally, the smaller the kidney stone, the higher the chance of spontaneous passage, and therefore the lower the chances that intervention will be required. Typically, a stone that is 5mm in greatest diameter has a 50% chance of spontaneous passage. For these and smaller stones observation with aggressive water ingestion may be advised to help the stone pass on its own.

For a stone that is located in the kidney or upper ureter, the most common treatment used is ESWL (extracorporeal shock wave lithotripsy). This involves using shock waves which are aimed at the stone using x-ray vision while patient lies in a water bath. The stones shatters into fine sand particles.

For stones located down lower in the ureter, the preferred treatment choice is ureteroscopy. This involves the passage of a thin viewing tube through the urethra, the bladder, and then up into the ureter. A wire basket in then inserted through the scope to remove the stone under direct visualization. If the stone is too large to remove intact, it first needs to be fragmented using laser so that the fragments can then be removed separately. For a short time, patients may require a catheter in the ureter to aid urinary drainage.

Other treatment options include:

• Percutaneous ultrasound lithotripsy
• Open stone surgery

Follow-Up
Depending on the type of stone found, we will discuss preventative measures to minimize the risk of future recurrence. Sometimes, blood and urine studies may be required to help better determine the etiology (origin) of stone formation and to help guide treatment. Regardless of the etiology, the mainstay of treatment is aggressive hydration, usually eight to twelve 8 oz. glasses of water daily. Diet modification may also be required depending on the type of stone. Medications may also be required.

To learn more
For general information about kidney stones and treatment options, click on this link: Kidney stones

Adult & Pediatric Urology, P.L.L.P
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