Whats The Urinary Tract How Does It Work
Your urinary tract is vital to your body because it gets rid of waste and extra fluid. Its made up of both your kidneys, two ureters, your bladder and your urethra. Each organ has an important job :
- Kidneys: Your fist-sized, bean-shaped kidneys are located on either side of your spine, below your rib cage. Each day they filter 120 to 150 quarts of your blood to remove waste and balance fluids. Your kidneys make one to two quarts of urine every day.
- Ureters: After your kidney creates urine, the liquid travels through the tube-shaped ureter to the bladder. There is one ureter per kidney. Kidney stones can pass through the ureters or, if theyre too big, get stuck in them. You may require surgery if the stone is too large.
- Bladder: Between your hip bones is your bladder, an organ that stores urine. It stretches to hold about one and a half to two cups.
- Urethra: Like a ureter, your urethra is a tube through which urine passes. Its the final stop of the urinary tract where your urine leaves your body. This is called urination.
How Can I Prevent Kidney Stones
There are several ways to decrease your risk of kidney stones, including:
- Drink water. Drink at least six to eight 8-ounce glasses every day . Staying hydrated helps you urinate more often, which helps flush away the buildup of the substances that cause kidney stones. If you sweat a lot, be sure to drink even more.
- Limit salt. Eat less sodium. You may want to connect with a dietician for help with planning what foods you eat.
- Lose weight. If youre overweight, try to lose some pounds. Talk to your healthcare provider about an ideal weight.
- Take prescriptions. Your healthcare provider may prescribe some medications that help prevent kidney stones. The type of medication may depend on the type of stones you get.
Surgery For Kidney Stones
Washington Universitys team of stone experts offers advanced treatment for kidney stones, with a focus on minimally invasive techniques, even for the largest stones.
Most procedures for small stones can be performed as same-day surgery, allowing you greater flexibility and a rapid return to work and other daily activities.
There are three main techniques for kidney stone surgery, and the choice of technique depends upon multiple factors, including the size and type of stone, medications you may be taking, your other medical problems and patient preference. Read on for a description of each technique.
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Types Of Kidney Stone Surgery
There are several different procedures for removing kidney stones that are too large to pass naturally.
Shock wave lithotripsy
The least invasive procedure, your surgeon uses high frequency sound waves to break up your kidney stones.
An ultrasound or X-ray will be used to locate your kidney stone, and a gel-filled cushion will be put on your abdomen or behind your kidney. The cushion allows sound waves to be transmitted to the stone, breaking it up into smaller pieces that you can pass in your urine.
Afterwards, imaging is again used to see how well its worked. You may need more than one session to successfully treat your kidney stone.
Shock wave lithotripsy is usually done under sedation or general anaesthetic.
Its generally a day procedure, so you can go home after the sedation or anaesthetic has worn off, as long as you can pass urine. Your doctor will ask you to drink lots of water to help with this.
Shock wave lithotripsy is relatively effective for stones up to 15 mm in diameter but less so for larger stones.
You cant have this procedure if you:
- are pregnant, as the sound waves and X-rays could harm your baby
- have a bleeding disorder
- have an untreated kidney infection, urinary tract infection, or kidney cancer
- have kidneys with abnormal structure or function.
- can be done as day surgery
- quick recovery.
Youll most likely be able to go home after youve recovered from the anaesthetic, as long as you can pass urine.
How To Do A Radical Nephrectomy Or Open Kidney Removal
Kidney removal Radical nephrectomy or open kidney removal 1 Your surgeon will make a cut about 8 to 12 inches long. 2 Muscle, fat, and tissue are cut and moved. 3 Your surgeon will also take out the surrounding fat, and sometimes the adrenal gland 4 The cut is then closed with stitches or staples.
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Can All Kidney Stone Patients Have This Kind Of Treatment
No. The size, number, location and composition of the stones are factors that must be taken into account when exploring treatment options. Patient size may limit use of the water bath method, but patients of many sizes can be treated with the water cushion method.
Also the stones must be clearly viewed by the x-ray monitor so the shock waves can be targeted accurately. If anatomical abnormalities prevent this, other methods of stone removal may have to be considered. Through examination, x-ray and other tests, the doctor can decide whether this is the best treatment for the patient. In some cases, extracorporeal shock wave lithotripsy may be combined with other forms of treatment.
Ask About The Treatment Based On The Reason:
Some treatments given on the advice of the doctor are used only for the treatment of stones made due to specific problems. Some medications help to remove your kidney stones, and other therapies can be used primarily to prevent kidney stones from being formed.
Calcium-based stones are the most common type of kidney stones. The medicines used to treat these include thiazides, potassium citrates, and orthophosphates.
The number of stones formed due to uric acid is found to be 5 to 10 percent. Potassium citrates, sodium bicarbonate, and allopurinol are used to treat them.
Cystine stones are rarely found, and they are usually treated with potassium citrates, penicillamine, tiopronin, or captopril.
Struvite stones are the result of repeated kidney infections or infections, and they may be challenging to treat with medicines. Your doctor may prescribe an antibiotic for the treatment of disease or infection and may also give you uterus inhibitor advice.
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What Other Treatment Choices For Kidney Stones Are Available
Drug treatment is being studied with such drugs as such as calcium channel blockers , steroids and alpha-adrenergic blockers. The idea is that the stone might be dissolved with medication. Other drugs such as K-citrate, thiazides or allopurinol are prescribed to prevent new stones from developing. Most doctors agree that more medical trials are needed.
When SWL is not appropriate or doesn’t work, some people will need ureteroscopy, a technique that goes through the bladder to reach the stone or percutaneous nephrolithotomy, a technique that goes through a small incision created in your back. Some people, in extremely rare cases, even need open surgery, a technique that involves a larger incision in your abdomen. The medical terms for kidney stone surgery are ureterolithotomy or nephrolithotomy.
Medical Therapy For Kidney Stones
Most evidence suggests that stones less than 10 mm in diameter have a reasonable chance of passing through the urinary tract spontaneously. You may be offered medical expulsive therapy using an alpha blocker medication, such as tamsulosin. Its important to understand that this is an off-label use of the drug. Rarely, tamsulosin causes a condition called intraoperative floppy iris syndrome that can complicate cataract surgery.
Not all experts feel MET is worthwhile, and its use remains controversial. Discuss your options with your doctor or a urologist.
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What Does The Treatment Involve
There are two ways to remove stones using shock wave treatment. In one method, the patient is placed in a tub of lukewarm water. Using x-rays or ultrasound to pinpoint the location of the stones, the body is positioned so that the stones are targeted precisely. In the second, more common method, the patient lies on top of a soft cushion or membrane through which the waves pass. About 1-2 thousand shock waves are needed to crush the stones. The complete treatment takes about 45 to 60 minutes.
Is Kidney Stone Surgery Serious
Well, I completely understand your concern, so now let us explore a bit more about kidney stone surgery complications. As far as Shock wave lithotripsy is concerned, the biggest issue is that, sometimes stone dissolution may not take place in 100% of all attempts. As previously described, this procedure is not good enough if you have a stone in the lower pole of your kidney and if the size of your stone is more than 1 cm. Furthermore, when the patient is obese, re-treatments may be required since in these patients visualizing kidney stone or approaching it itself would have complications.
This SWL technique may not work for stone composition types too. Especially those that are dense in nature. However, this technique has an excellent patient recovery with a less than 1% risk of sepsis or bleeding post the procedure.
Moving on to ureteroscopy combined with laser, this technique is more efficient in removing most stones compared to SWL. This technique as previously described also works for different stone types.
Getting a laser treatment for kidney stone removal requires considerable expertise from your treating consultant. If done right, recovery and complications are even lesser than the SWL procedure.
PCNL on the other hand, is always a last resort option and is reserved only for really large and pesky stones! PCNL is definitely associated with a few complications and requires post procedure admission and bed rest.
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Add Lemons To Your Diet To Remove Kidney Stones:
Squeeze a lemon into water or add lemon in the salad.
Lemon contains high amounts of citric acid, which is believed to be effective in breaking calcium-based kidney stones. As stones collapse, it is easy to pull them out and less painful.
Try to drink 1/2 cup of pure lemon juice every day.
Note that other juices are less active. In fact, instead of breaking those stones, cranberry juice, apple juice and seasonal, etc. can increase the risk of kidney stone development.
How Common Are Kidney Stones
Researchers have concluded that about one in ten people will get a kidney stone during their lifetime. Kidney stones in children are far less common than in adults but they occur for the same reasons. Theyre four times more likely to occur in children with asthma than in children who dont have asthma.
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Which Is Better Nephrectomy Or Laparoscopic Kidney Removal
Laparoscopic surgery involves smaller incisions and has a faster recovery time. Recovering from a nephrectomy can take several weeks. It may be very painful. As with any surgery, complications such as infections are possible.
Read about surgery to remove part of your kidney or your whole kidney . Surgery can remove: The surgery aims to cure the cancer, if the surgeon can remove the cancer completely. If surgery is unlikely to cure your cancer, it can still help.
The Evaluation For Kidney Stones
If your , imaging is often the first step in an evaluation. For many years the standard of care was a type of abdominal x-ray called an intravenous pyelogram . In most medical centers, this has been replaced by a type of computed tomography called unenhanced helical CT scanning. In some cases, such as when a person has impaired renal function or a contrast dye allergy, renal ultrasound may be used as an alternative.
You will also have blood tests, including tests for renal function . Your doctor may suggest other blood tests as well. A urinalysis will be obtained and if infection is suspected, a urine culture will be sent.
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Kidney Stone Surgery Recovery
Our urology experts will be there for you throughout your recovery to monitor your progress and ensure you are in good health.
We may prescribe medication like tamsulosin to relax and open your ureter for a period after surgery. Tamsulosin can make it easier for stones or stone fragments to pass. We may also have you use a strainer to collect stone pieces if they pass in your urine so we can test them.
If we placed a temporary stent in your ureter during surgery, we will remove it during an office visit two to 10 days after your procedure.
What Other Treatment Choices Are Available
About 90 percent of stones pass through the urinary system without treatment. In cases where this does not occur, treatment to remove stones may be needed. Some stones may be dissolved by medicines. In other cases, one of the following methods of stone removal may be needed:
Percutaneous Stone RemovalWhen stones are quite large or in a location that does not allow effective lithotripsy, a technique called percutaneous stone removal may be used. In this method, the surgeon makes a small incision in the back and creates a tunnel directly into the kidney. A tube is inserted and the stone is removed through this tube.
Ureteroscopic Stone RemovalFor stones found in the lower part of the urinary tract, the doctor may pass a ureteroscope up into the bladder and ureter. A basket-like device may be passed through the tube to grasp and withdraw the stone.
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How Large Kidney Stones Are Treated
There are several methods for breaking down or removing large kidney stones, whether minimally invasive or surgically.
Extracorporeal shock wave lithotripsy is an outpatient procedure that requires either light sedation or anesthesia and usually lasts between 45 minutes and an hour. A lithotripsy uses shock waves that work to break up the kidney stone into much smaller pieces that will pass more easily through the urinary tract.
A ureteroscopy is generally an outpatient procedure that is performed under anesthesia. During this procedure, the surgeon will insert an ureteroscope through the urethra and bladder to the ureters. The ureteroscope is a thin, lighted, tube-like instrument with an eyepiece that allows the urologist to see the kidney stone. Once located, it can be retrieved or broken into smaller pieces using laser energy.
Sometimes, the surgeon will choose to place a stent in the ureter . If placed, it will be removed in approximately four to 10 days during an office visit.
Depending on its size and location, the urologist may choose to perform a Percutaneous Nephrolithotomy . This procedure requires general anesthesia, and may require an overnight stay in the hospital.
Contact Urology Austin to schedule an appointment at the location nearest you.
Are There Any Foods Or Drinks That Help Treat Kidney Stones Are There Any Home Remedies
There are three liquids rumored to help with kidney stones:
- Cranberry juice. Although cranberry juice can help prevent urinary tract infections , it doesnt help with kidney stones.
- Apple cider vinegar. Vinegar is acidic and it can sometimes create changes to your urine, which helps with kidney stones. But, this doesnt always help. Talk to your healthcare provider about the use of vinegar.
- Lemon juice. Lemon juice is rich in citrate, which can help prevent kidney stones from forming. Citrates are found in several citrus fruits including lemons, limes, oranges and melons.
- Coffee. Studies show that coffee may decrease your risk of developing kidney stones.
Avoid soda and other drinks with added sugar or fructose corn syrup. They increase your risk.
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Understand That Small Stones Are Easier To Take Out Naturally Than The Bigger Stones:
A stone can be cured by home remedies, mostly depending on the size of the stone.
Home remedies are generally effective on 1/10-inch, i.e. about 3 mm smaller stones.
Once reaching an approximately 1/10-inch size of kidney stones, i.e., close to 3mm, the probability of self-removal from home remedies is only about 20 percent.
Patients whose kidney stones are about 2/5-inch or about 1 centimeter in size they always require professional medical treatment.
What Causes Kidney Stones
Kidney stones are formed from substances in your urine. The substances that combine into stones normally pass through your urinary system. When they dont, its because there isnt enough urine volume, causing the substances to become highly concentrated and to crystalize. This is typically a result of not drinking enough water. The stone-forming substances are:
- Cloudy, foul-smelling urine, fever, chills or weakness which might be a sign of a serious infection.
- Blood in the urine.
Most pediatric kidney stones remain in the kidney, but up to a third may migrate from the kidney and get stuck in a ureter. Stones that remain in the kidney, although often painless, can be the source of recurrent urinary tract infections. Those that lodge in the ureter can create severe colicky pain.
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Try Shock Wave Lithotripsy To Remove Kidney Stones:
Extracorporeal Shock Wave Lithotripsy is used to treat large kidney stones from 80 to 90 mm, as long as the stones are not in the lower third part of your ureter.
With Extracorporeal Shock Wave Lithotripsy , the patient is placed under a machine called a lithotripter. This machine sends high-pressure sound waves to the patients body. These shock waves are capable of doing small pieces of large stones, which can later be extracted from the urine passage in general.
How Successful Is Shock Wave Lithotripsy
ln those patients who are thought to be good candidates for this treatment, some 50-75% are found to be free of stones within three months of SWL treatment. The highest success rates seem to be in those patients with smaller stones .
After treatment, some patients may still have stone fragments that are too large to be passed. These can be treated again if necessary with shock waves or with another treatment.
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