What Are The Treatment Options For Bladder Stones
- Cystolitholapaxy crushing the stones followed by irrigation to remove fragments. A cystoscope is inserted through the urethra and into the bladder. Ultrasound waves or lasers are transmitted from the cystoscope and aimed at the stones, breaking them up. They are then flushed out. The patient will have either a local or general anesthetic for the procedure. Complications are rare, but if they do occur may include urinary tract infections, a bladder tear, and bleeding. Patients are usually administered antibiotics to reduce infection risk. Approximately one month after the cystolitholapaxy there is a follow-up meeting with the doctor to check that no fragments remained behind in the bladder.
- Surgery if the bladder stones are too hard to crush, or too large, open surgery may be needed. The surgeon makes an incision just above the pubic hair, and another incision in the bladder and directly removes the stones. If there is an underlying condition linked to bladder stones, such as an enlarged prostate, this may be corrected too. The patient may need to use a urinary catheter until the bladder heals.
Kidney Stones Require Prompt Medical Care
Symptomatic kidney stones require medical care, regardless of the type or number of symptoms you have and regardless of the severity of your symptoms. Left untreated, even a single stone can cause kidney damage. If you have a history of kidney stones, it could be a sign of an underlying problem. As a top urologist in New York City, Dr. Michael Rotman is skilled in diagnosing and treating kidney stones so men and women can prevent serious complications and enjoy better health. If you’re having kidney stone symptoms or if you’ve had multiple kidney stones in the past, book an appointment online today.
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Can Kidney Stone Pain Radiate To Upper Back
The pain from the kidneys can be felt in the sides, middle to upper back, and under the ribs. The pain can also progress to other parts of the body. There is swelling or obstruction of one or more of your kidneys. The most common symptoms are: a sharp, stabbing pain in your lower back or side that feels like youre being stabbed with a knife or knife-like object.
This pain can be so intense that you cant stand up or sit down. You may feel dizzy or lightheaded, and you may have a feeling of burning or tingling in or around the area where you feel the pain.
If you have any of these symptoms, call your doctor right away and tell him or her about any other symptoms you are having, especially if they are severe or have lasted for more than a few hours. Your doctor may want to do a physical exam to rule out other conditions that may be causing your pain, like a heart condition, kidney disease, high blood pressure, diabetes, liver disease or other health problems.
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What Is Kidney Pain
Kidney pain is discomfort near your kidneys. Your kidneys are two bean-shaped organs located just below your ribcage, on each side of your spine. Kidney pain doesnt always mean theres a problem with your kidneys specifically but it does usually indicate an issue somewhere in your urinary system.
Kidney Stone Symptoms Vary Between Men And Women
Just as males are more likely than females to develop kidney stones, they also feel symptoms differently. It is thought that the differences in the male and female anatomy are the primary cause. Men feel the pain in their abdomen, lower back or groin region as the stone passes through the narrow ureter. It can also cause a dull, achy or throbbing pain in the upper abdomen similar to the sensation of gastric discomfort. Females, however, express their symptoms as menstrual cramps that escalate from dull aches to grimacing pain.
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What Happens To Patients
As a result, there is no standard of care regarding how to optimally manage such patients. In all cases it is first imperative to rule out other potential sources of pain however, such workups often end with the same result a patient with bothersome flank pain and evidence of one or more nonobstructing stones on imaging.
Lacking a physiologic explanation to explain their symptoms, patients with pain and non obstructing stones are often sent for detailed workups, secondary and tertiary consultations and referral to pain specialists and even psychiatrists. However, in an age where flexible ureteroscopy can be performed quite safely and on an outpatient basis one must wonder whether such patients are being treated appropriately.
Why Passing A Kidney Stone Can Be So Painful
Think of the urinary tract system as your bodys plumbing system, explains Timothy F. Lesser, MD, a urologist at Torrance Memorial Medical Center in Los Angeles. The kidney makes urine, which spills into the ureter, a tiny tube that transports the urine from the kidney down to the bladder. The bladder fills, then empties. The concept of passing a stone means a stone travels from the kidney down to the bladder, and then through the length of the ureter, he says. The stone leaves the urinary tract through the urethra, the tube that transports urine outside the body from the bladder.
A stone passing is so painful because the kidney itself is exquisitely sensitive, explains Dr. Lesser. When a stone blocks the flow of urine through the urinary tract, backed-up urine can put pressure on the kidney, resulting in pain.
It is thought that the kidney itself does not have nerves with classical pain fibers, says John C. Lieske, MD, a consultant in the division of nephrology and hypertension at the Mayo Clinic in Rochester, Minnesota. But the tissue surrounding the kidney called the capsule does contain nerve fibers that transmit pain. Backed-up urine swells and expands the capsule, he says.
This swelling activates those nerve fibers, causing signals that are interpreted by the brain as intense, visceral pain, says Prakash N. Maniam, MD, a urologist affiliated with Oviedo Medical Center Doctors Hospital in Florida.
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What Your Physician Isnt Telling You And What They Dont Know
Diagnosing tight hip flexors is tricky.
If youve seen a therapist or physician, chances are they werent able to pinpoint the issue.
Buried so deep within your abdomen, its no wonder identifying it as the root cause of any of your symptoms is difficult to do.
Its why tight hip flexors are left undiagnosed and untreated for far too long, as physicians look for a simpler explanation.
So understand that this its not your fault.
However, knowing this hands you the power to finally do something about it before its too late.
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What Is Known To Date
Such patients are frequently encountered. Despite a lack of physiologic explanation as to why these non-obstructing stones may cause pain, there is emerging evidence that they do and therefore that removal can cure it.
In 2006 Taub et al. described outcomes of twenty such patients who had chronic flank pain as well as radiographically evident calcifications within their papillae without obvious collecting system stones. Ureteroscopy with laser papillotomy to unroof and remove all evident stone was performed on twenty seven kidneys. Pain improvement was seen in 85% of cases with a durable improvement for greater than one year in nearly 60% of cases.
This study was then repeated on a multi-institutional level with 65 patients undergoing similar procedures over a ten year period. Overall there were 176 procedures performed in this cohort with patients reporting less pain after the procedure 85% of the time. The mean duration of response was 26 months with 60% of patients having sustainable improvements in their pain levels for over one year.
Finally, this clinical scenario is seen commonly enough that it garnered its own nickname at Massachusetts General Hospital where it has been described as small stone syndrome. In a retrospective review of patients treated there with ureteroscopic removal of small nonobstructing stones for reasons related to chronic pain, 11/13 patients reported being pain free after the procedure with the other two noting a partial response.
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Common Kidney Stone Symptoms
Kidney stones can be debilitating and painful . While a stone forms in the kidney, there may be no signs or symptoms. Most people start experiencing symptoms once the formed stone passes into the ureter . The most common kidney stone symptoms include:
Blockage Of Blood To The Kidney
A blockage of blood to the kidney is called a renal infarction or a renal vein thrombosis. This happens when the blood supply to and from the kidney is suddenly slowed or stopped. There are several causes, including a blood clot.
Blood flow blockages to the kidney typically happens on one side. Symptoms include:
- severe side or flank pain
- lower back pain or ache
- stomach tenderness
- blood in the urine
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Could Left Kidney Be Causing Shoulder Blade Pain
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How To Get Relief From Kidney Stone Pain
When pain does occur, it can be so severe that many patients have to go to the closest emergency room to seek immediate treatment. Often a single dose of pain medication given by an ER doctor is enough to alleviate the pain for a prolonged period of time, allowing the stone to pass, says Lieske.
While narcotic pain medications can be carefully given for this purpose, studies suggest that nonsteroidal anti-inflammatory drugs milder pain medications with fewer side effects can be just as effective. A 2018 review of 36 clinical trials that compared NSAIDs with stronger pain medications for kidney stone pain relief found that NSAIDs were equivalent when it came to pain reduction and led to fewer side effects. 30977-6/fulltext” rel=”nofollow”> 7)
Tamsulosin , a type of medication known as an alpha-blocker, is also widely used to help relax the muscles of the ureter, increasing the chance of passing the stone and helping reduce symptoms of pain, Bechis notes. Although some evidence suggests this medication may not add as much benefit as previously thought, he adds. A 2015 study found that tamsulosin didnt help stones pass. 60933-3/fulltext” rel=”nofollow”> 8) However, a 2018 study of more than 3,000 participants did find that those who took tamsulosin passed stones more quickly and required less pain relief medicine than those who took a placebo.
How long does kidney stone pain last? It depends on how long it takes to pass the stone.
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When To Seek Immediate Treatment From A Doctor
You may be experiencing one or more of the above symptoms and think, Should I see a doctor? Are my symptoms that bad? You should make an appointment with a urologist when you experience any of the above symptoms for an extended period of time and particularly if you start to experience any of the following:
- Pain so extreme that its hard to move or get up
- Blood in the urine
- Nausea and vomiting from pain radiating from your right side
- Fever and chills accompanying the pain
- Difficulty passing urine
Causes Of Kidney Stones
According to the National Library of Medicine, kidney stones occur when there is an overabundance of calcium or other minerals in urine 2. These minerals crystallize and form stones. Stones obstruct the vessels in the kidneys or along the urinary tract. Some stones are large enough to restrict the flow of urine, which can cause the kidneys to swell. This swelling causes intense pain. Pain resulting from kidney stones can be felt in the abdomen, back or groin.
- According to the National Library of Medicine, kidney stones occur when there is an overabundance of calcium or other minerals in urine 2.
- Some stones are large enough to restrict the flow of urine, which can cause the kidneys to swell.
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Kidney Stones & Shoulder Pain
Due to the complexity of the human body, the site of pain is not always the site of the related illness or injury. The National Library of Medicine indicates that this can be the case for kidney stones 2. Sometimes pain is felt directly at the site of the kidneys, but sometimes it is felt in the groin, or in various areas of the mid to lower back. While there do not appear to be any specific ties to kidney stones and shoulder pain, there are situations where the two might be–or just appear to be–connected.
Pain Or Burning With Urination
If it hurts to pee, a kidney stone may be to blame. Some people experience this type of pain as a stone travels through the ureter, getting closer to the bladder.
But its more likely, Dr. Pearle says, that any burning with urination is caused by an infection, such as a urinary tract infection, than by kidney stones. In one study, 8% of kidney stone patients had a UTI.
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Kidneys And Kidney Stones
The kidneys are bean-shaped, fist-sized organs located under the ribs. Their purpose is to filter waste products and excess fluid from the blood, and produce hormones that play a role in blood and bone formation and controlling blood pressure.
The kidneys are part of the urinary system, which includes the bladder, ureters , and urethra .
Kidney stones occur when chemicals and minerals, in the urine combine to form solid material inside the kidneys.
Kidney stones can vary in size from a grain of sand to bigger than a golf ball. They can be smooth or they can have jagged edges. Small kidney stones can cause pain as they pass through the urinary tract. Large stones can become stuck in the kidney, ureter, or bladder causing pain and blockage of urine flow. This can lead to infection and kidney damage.
A person can have a single stone or many of them.
What Causes Kidney Pain
Kidneys drain urine to the bladder via tubes called ureters. Your bladder is emptied via the urethra. Problems in any of these areas can cause pain, and may be caused by:
If you have had kidney stones in the past, it may not always be necessary to have a computed tomography scan, which exposes you to radiation. Ask your doctor if a CT scan is necessary for you. For further information, visit the Choosing Wisely Australia website.
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Prevention Of Future Stones
Once your health care provider finds out why you are forming stones, he or she will give you tips on how to prevent them. This may include changing your diet and taking certain medications. There is no âone-size-fits-allâ diet for preventing kidney stones. Everyone is different. Your diet may not be causing your stones to form. But there are dietary changes that you can make to stop stones from continuing to form.
Drink enough fluids each day.
If you are not producing enough urine, your health care provider will recommend you drink at least 3 liters of liquid each day. This equals about 3 quarts . This is a great way to lower your risk of forming new stones. Remember to drink more to replace fluids lost when you sweat from exercise or in hot weather. All fluids count toward your fluid intake. But itâs best to drink mostly no-calorie or low-calorie drinks. This may mean limiting sugar-sweetened or alcoholic drinks.
Knowing how much you drink during the day can help you understand how much you need to drink to produce 2.5 liters of urine. Use a household measuring cup to measure how much liquid you drink for a day or two. Drink from bottles or cans with the fluid ounces listed on the label. Keep a log, and add up the ounces at the end of the day or 24-hour period. Use this total to be sure you are reaching your daily target urine amount of at least 85 ounces of urine daily.
Reduce the amount of salt in your diet.
Eat the recommended amount of calcium.
What Are Common Kidney Pain Symptoms
People with kidney pain may experience different symptoms. Some of the most common kidney pain symptoms include:
- A constant, dull ache in your back.
- Pain in your sides, under your rib cage or in your abdomen.
- Severe or sharp pain that comes in waves.
- Pain that spreads to your groin area.
- Kidney pain is often accompanied by nausea or vomiting, especially if the pain is due to kidney stones.
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