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When Should Kidney Stones Be Removed

How Can I Tell If I Have A Kidney Stone

Removal of Kidney Stone

Routine screening for kidney stones common but not recommended for all people.

Kidney stones can be detected using imaging such as X-rays, ultrasound, CT scan, or MRI. The best imaging currently available for kidney stone detection is a CT scan.

If you have crystals in your urine, that does not mean that you have a kidney stone. Crystals in the urine are common. If you have crystals in your urine along with other symptoms of kidney stones, you should see a doctor for an exam and imaging.

Medication For Kidney Stones

For most people with recurrent calcium stones, a combination of drinking enough fluids, avoiding urinary infections, and specific treatment with medications will significantly reduce or stop new stone formation.

Certain medications such as thiazide diuretics or indapamide reduce calcium excretion and decrease the chance of another calcium stone. Potassium citrate or citric juices are used to supplement thiazide treatment and are used by themselves for some conditions where the urine is too acidic.

For people who have a high level of uric acid in their urine, or who make uric acid stones, the medication allopurinol will usually stop the formation of new stones.

Symptoms You Might Experience

Some symptoms you may experience after kidney stone removal can seem alarming, but are usually normal. These include:

  • Pain and nausea: These are common and occur as kidney stone fragments pass through your urinary tract and out of your body. Your healthcare provider may prescribe you pain and anti-nausea medications to ease these symptoms.
  • Mild discomfort at incision sites, if any: Ask your practitioner about how to best care for these sites, including when you can safely shower.
  • Blood in urine painful urination : This may occur after ureteroscopy with ureteral stent placement. Most stents are removed around one to two weeks after surgery, but be sure to confirm the timing of this with your healthcare provider.
  • Soreness at tube insertion site: If you have a nephrostomy tube placed, be sure to follow your practitioner’s instructions for keeping the skin around the tube dry and clean.

Of course, if you are ever concerned about any symptoms you are experiencingespecially if they persist for more than a few dayscall your surgeon.

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Kidney Stone Treatment Options

We work with patients in every stage of their condition, creating a personalized plan whether surgery is needed or not. We also try to identify factors that may be causing the stones, so we can keep current stones from getting larger and reduce the risk of developing future stones.

When suspected of having a kidney stone, we take a history, perform a physical, exam, and obtain radiological imaging. Studies may include a plain x-ray of the abdomen, a renal ultrasound, or a CT scan. They help us determine the location of the stone, its size, the degree to which the stone may be causing an obstruction to urine flow, and what types of therapy would be appropriate for management.

Purpose Of Kidney Stone Surgery

Your Kidney Stones Will Be Removed In Case You Take This ...

The purpose of kidney stone surgery is to remove a stone in order to reduce symptoms and/or reverse a medical condition associated with the presence of the stone .

Specific indications for kidney stone surgery include:

  • Ureteral stones greater than 10 mm
  • Uncomplicated distal ureteral stones less than 10 mm that have not passed after four to six weeks of observation
  • Symptomatic kidney stones without any other explanation for the patient’s pain
  • Ureteral or kidney stones in pregnant women that have not passed after an observation period
  • Persistent kidney obstruction related to stones
  • Recurrent urinary tract infections linked to stones

Aside from the above indications, emergency surgery to remove a kidney stone may be warranted in the following cases:

  • If the flow of urine from both kidneys is blocked and there is acute kidney injury
  • If a patient has acute kidney injury from an obstructing stone and only one functioning kidney
  • If a patient has an obstructing stone and a urinary tract infection

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Is It Urgent That The Patient Be Treated With A Procedure Like This

lf the stone does not pass on its own, it will require treatment. lf you have an infection, severe pain, or if your kidney function is threatened, your doctors will act quickly. lf you only have one kidney or have had a kidney transplant, your stone will be treated more quickly. lf you have large stones or stones in both kidneys, your doctors will not wait to treat you.

Kidney Stone Size Chart And Its Features

This is a simple kidney stone size chart that that provides important information about the chances of passing stones naturally, time taken, and treatment required for various sizes of the kidney stones. More types of kidney stone charts can be possible to show different types of information pieces about kidney stones and their sizes.

Size of kidney stones

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Does The Patient Need Anesthesia

Yes, even though there is no incision, there will be pain. You and your doctor will discuss whether light sedation and local or general anesthetics will be used. The choice depends on the technique, the type of stone and the patient. SWL can be delivered with just mild sedation, but in general, some type of anesthesia–either local, regional or general–is used to help the patient remain still, reduce any discomfort, and this improves the breaking of the stone.

What Can The Patient Expect After Treatment

Removal of kidney stones: URS

After treatment is complete, the patient can move about almost at once. Many people can fully resume daily activities within one to two days. Special diets are not required, but drinking plenty of water helps the stone fragments pass. Some pain may occur when the fragments pass, which begins soon after treatment and may last for up to four to eight weeks. Oral pain medication and drinking lots of water will help relieve symptoms.

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Urinary System Parts And Their Functions:

  • Two kidneys. A pair of purplish-brown organs located below the ribs toward the middle of the back. Their function is to:
  • Remove liquid waste from the blood in the form of urine
  • Keep a stable balance of salts and other substances in the blood
  • Produce erythropoietin, a hormone that aids the formation of red blood cells
  • Regulate blood pressure

The kidneys remove urea from the blood through tiny filtering units called nephrons. Each nephron consists of a ball formed of small blood capillaries, called a glomerulus, and a small tube called a renal tubule. Urea, together with water and other waste substances, forms the urine as it passes through the nephrons and down the renal tubules of the kidney.

  • Two ureters. Narrow tubes that carry urine from the kidneys to the bladder. Muscles in the ureter walls continually tighten and relax forcing urine downward, away from the kidneys. If urine backs up, or is allowed to stand still, a kidney infection can develop. About every 10 to 15 seconds, small amounts of urine are emptied into the bladder from the ureters.
  • Bladder. A triangle-shaped, hollow organ located in the lower abdomen. It is held in place by ligaments that are attached to other organs and the pelvic bones. The bladder’s walls relax and expand to store urine, and contract and flatten to empty urine through the urethra. The typical healthy adult bladder can store up to two cups of urine for two to five hours.
  • What Would Happen If Kidney Stones Are Left Untreated

    In situations where there is a kidney stone which is large enough that it cannot pass through the urine can block the urinary tract which may cause obstruction of urine. This obstruction further causes pain. If the individual leaves the kidney stone condition as is and does not get it treated, the pain might go away after some time and the individual may think that the problem has been dealt with however, in actuality the exact opposite happens and the blocked kidney stops functioning.

    If the condition of kidney stone is left untreated then it may lead to complete shut down of the kidney resulting in renal failure which will then have severe repercussions for the affected individual. In some cases, the stone may even cause the kidney to get ruptured which is even more challenging to treat.

    In conclusion, it is extremely important to treat a kidney stone as soon as it is diagnosed. If the kidney stone is small, the physician may give some pain killers and advice to drink more water to allow the stone to pass through the kidneys. However, if the stone is big then laser treatments may be required to treat this condition. If left untreated, kidney stones may lead to complete shut down of the kidney causing permanent damage and even complete failure of the kidney to function which can be catastrophic for the individual.

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    Large Kidney Stones Require More Extensive Treatment

    Large kidney stones are stones that measure approximately 5 mm or larger. Based on their size, they may have trouble moving through the urinary tract out of the body. In fact, they are prone to become lodged causing severe pain and other symptoms.

    Large kidney stones require intervention for removal, typically, a surgical procedure. Reasons that initiate surgical treatment include:

    • A stone that becomes lodged and wont pass on its own.
    • Severe pain that makes it difficult to wait for the stone to pass on its own.
    • Having an infection.
    • Having a stone that is blocking the flow of urine from the kidney.

    Kidney Stone Signs And Symptoms

    Kidney Stone Surgery Process

    Kidney stones are conglomerations of crystals that form when concentrations of minerals in the urine become very high. As their name implies, stones almost always start in the kidneys. They may cause problems there, or may not be noticed until they move into the ureter . Once stones enter into the ureter the can obstruct the drainage of urine which generally causes symptoms such as pain in the upper back or lower abdomen, nausea, vomiting, and blood in the urine. Many stones will pass down the ureter, into the bladder and then be voided with urine. Occasionally stones can remain lodged in the ureter or within the bladder.

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    How Successful Is Extracorporeal Shock Wave Lithotripsy

    In those patients who are thought to be good candidates for this treatment, about 70 to 90 percent are found to be free of stones within three months of treatment. The highest success rates seem to be in those patients with mobile stones that are located in the upper portions of the urinary tract . After treatment, some patients may still have stone fragments that are too large to be passed. These can be treated again if symptoms persist.

    Early Signs Of Passing Kidney Stones

    Kidney stones often cause extreme pain while they pass via urine however, all kidney stones are not painful. Some kidney stones present noticeable symptoms while they are passed and therefore give a clear indication that you need to visit a doctor. Some of the early signs of passing kidney stones are mentioned below:

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    Can A Large Kidney Stone Cause An Injury

    Your risk of injury from a kidney stone can go up based on the size and location of the stone. A larger stone could get stuck in a ureter, causing pressure to build up. This can lead to renal failure and, in the worst-case scenario, you could lose your kidney. The chance of passing a 1 cm stone is less than 10%, and stones larger than 1 cm typically dont pass.

    Frequently Asked Questions About Shockwave Lithotripsy

    Kidney Stone Removal | Kidney Stone: Causes, Signs, and Treatment Methods
    Where are your SWL services available?

    We offer SWL services at our Barnes-Jewish Hospital and Barnes-Jewish West County Hospital locations

    Why should I choose SWL?

    SWL is an outpatient procedure, and one of the preferred treatments for small- to medium-sized stones. It is considered a safe and effective procedure with an excellent track record. As it is an outpatient procedure, you will be home just a few hours after the procedure. Recovery is generally very rapid.

    Does SWL have any limitations?

    As with any technology, there are limitations. Certain types of stones are very hard and resistant to breakage with shockwaves. Other, less common stones are invisible on X-ray, which means that they cannot be targeted for treatment. Therefore, if you have a history of cystine, monohydrate or uric acid stones, SWL may not be the best treatment for you.

    Also, very large stones or stones that have traveled into the lower part of the urinary tract may be better treated by other methods. There are also some patient factors, including other medical conditions, which may affect your suitability for SWL. For instance, patients who are on blood-thinning medications or who may be pregnant should not undergo SWL procedures.

    Is SWL associated with any side effects?
    How can I make an appointment to discuss SWL with a Washington University urologist?

    Please call 362-8200 to schedule an appointment at any of our clinic locations.

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    What Does It Feel Like To Have A Kidney Stone

    Everyone experiences kidney stones differently. Typically, kidney stones within the kidney do not cause pain.

    If a stone falls onto the opening where the kidney meets the ureter or passes into the ureter, this can prevent urine from draining out of the kidney. This backing up of urine can lead to back pain just below your ribs. Sometimes the pain can be severe enough to cause nausea and vomiting.

    As a stone moves, the blockage of urine may be relieved and symptoms may improve or go away. The pain may return if the stone begins to cause blockage of urine again. This changing of symptoms is called renal colic.

    Blood in the urine may be a sign of kidney stones. Sometimes the blood isnt visible to the naked eye and must be detected by a urine test.

    If a stone is able to pass down the ureter and close to the bladder, the pain may move to the front of the abdomen, near the pelvis.

    Stones very close to the bladder can cause pain that is felt in the genitals. A stone that reaches the bladder can cause burning with urination or changes in how often or how urgently you need to urinate.

    Medical Treatment To Prevent Stones

    Factors which increase the risk of stones include:

    • Gender: Men are more likely than women to form kidney stones, although the rate is increasing faster in women and soon men and women might have equal risk of kidney stone formation
    • Family history: If you have family members with stones, you have a higher risk of developing kidney stones
    • Diet: Diets high in fat, processed sugar, and salt place people at risk of forming kidney stones
    • Weight: Obesity is strongly associated with kidney stones
    • Personal history: If you formed your first stone when you were young, or if you have already formed more than one stone, you are at greater risk of having more stones

    The cornerstone of medical treatment to prevent stones is increasing fluid intake. It is recommended that you drink enough fluid to produce 2 liters of urine each day. That is the equivalent to the amount of fluid in a 2 liter soda bottle. Its important that you spread this out over the entire day rather than drinking the whole amount at one time. It is recommended that you include a glass of water just before bedtime. The goal is to make sure your urine has the appearance of water. If the urine is yellow then you probably arent drinking enough.

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    What Is Shock Wave Lithotripsy

    Shock Wave Lithotripsy is the most common treatment for kidney stones in the U.S. Shock waves from outside the body are targeted at a kidney stone causing the stone to fragment. The stones are broken into tiny pieces. lt is sometimes called ESWL: Extracorporeal Shock Wave Lithotripsy®.

    These are what the words mean:

    • extracorporeal: from outside the body
    • shock waves: pressure waves
    • lithotripsy

    So, SWL describes a nonsurgical technique for treating stones in the kidney or ureter using high-energy shock waves. Stones are broken into “stone dust” or fragments that are small enough to pass in urine. lf large pieces remain, another treatment can be performed

    Pain After Kidney Stone Removal And Stent Causes:

    Treatment to remove a 27 mm Kidney Stone without Surgery?

    Every persons body reacts differently to presence of stent in the kidney after kidney stone removal. The stent is generally well tolerated by patients.However, some patients may experience mild abdominal discomfort and urinary irregularities due to the stent. According to patient studies, nearly 80% patients experience stent-related symptoms.

    The possible reasons behind discomfort and pain after kidney stone removal and stent placement are:1. Stent displacement due to physical activity can cause abdominal pain and discomfort and mild bleeding while urinating.2. Mechanical stimulation of bladder coil causes bladder irritability. This causes increase in frequency of urination.3. Urgency also occurs as a direct result of presence of stent.4. Flank pain or abdominal pain occurs due to reflux of urine back to the kidneys. It can also occur due to encrustation of the stent.5. Supra-pubic pain occurs due to irritation or infection of bladder.

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    How Long Does It Take To Pass A Kidney Stone

    The amount of time it can take for you to pass a kidney stone is different from anothers. A stone thats smaller than 4 mm may pass within one to two weeks. A stone thats larger than 4 mm could take about two to three weeks to completely pass.

    Once the stone reaches the bladder, it typically passes within a few days, but may take longer, especially in an older man with a large prostate. However, pain may subside even if the stone is still in the ureter, so its important to follow up with your healthcare provider if you dont pass the stone within four to six weeks.

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