Kidney stones are formed by the crystallization of salts inside your kidneys. Kidney stones are very common; the lifetime risk of having a stone is up to one in ten. After having one stone, the risk of getting another is up to 10% per year. 

Symptoms

A kidney stone can cause symptoms if it moves in the kidney or passes into the ureter, which is the small tube that connects the kidney to the bladder. If a stone gets lodged in the ureter, it may block the flow of urine and cause the kidney to swell, causing pain.

Make an appointment with us if you have any symptoms that worry you.  Symptoms of kidney stones include:

• Severe, gripping pain in the side and back (flank). The pain can travel or radiate down to the groin or lower abdomen. The pain can fluctuate in severity and come in waves.

• Sweating, nausea and vomiting.

• Cloudy or foul-smelling urine.

• Fever and chills may indicate an infection is present.

• Frequency. Urinating more frequently or smaller volumes than normal.

• Urgency. A persistent need to urinate even when the bladder is not full.

Causes

Often, there are no single identifiable causes. Most kidney stones are calcium stones. Several factors can increase your risk of kidney stones. One of the biggest risk factors is dehydration. Dehydration increases the concentration of electrolytes in your urine which can then clump together to form a crystal, which can eventually become a stone. Stones can also form when your urine contains more crystal-forming substances or lacks crystal-preventing substances, creating an ideal microenvironment for stones to form.

Diagnosis

We may perform some tests to confirm kidney stones and rule out any underlying causes for them.

• Blood tests. Blood test results help us monitor the health of your kidneys.

• Urine testing. A urine test is done to exclude a urinary infection. If stones are recurrent, a 24-hour urine collection test may be needed to check there are no underlying metabolic causes the kidney stones. 

• Imaging. CT scan is the best for identifying kidney stones and may reveal even tiny stones. Abdominal X-rays and ultrasound can also be used in some cases.

• Stone analysis of passed stones. Urinating through a strainer may help catch any stones that you pass. Analysis of the stone in the lab will tell us about the composition of your kidney stones. This can help us identify what's causing your kidney stones and form a personalized plan to prevent more kidney stones in the future.

Treatment

Treatment depends on the size, location and type of stone. Small stones may pass with medical treatments. Larger stones may need minimally invasive laser or other treatments. 

Treatments include:

• Pain relievers. Passing a small stone can cause some discomfort. 

• Medical expulsion therapy. Taking medications can relax the muscles in your ureter and help you pass the kidney stone more quickly and with less pain. 

• Stent. A small tube (stent) can be placed in the ureter to relieve swelling and promote healing.

• Minimally-invasive laser fragmentation. We use a small camera tube (ureteroscope) to pass through the urethra and bladder to directly see the stone and fragment it with a laser fiber under anesthesia. This minimally invasive technique is associated with rapid recovery and return to daily activities. Most cases are performed as day-stay or overnight procedures. After a laser fragmentation procedure, you will have a stent placed which will achieve a few things: 1) allow the ureter and kidney to recover from the blockage caused by the stone, 2) allow small fragments to pass in urine, and 3) allow easy access to ureter and kidney if further laser treatment is required.

• Extracorporeal shock wave lithotripsy (ESWL). For some stones, ESWL may be used. ESWL uses sound waves to create strong vibrations  that break the stones into smaller pieces. These smaller fragments may pass spontaneously or be easier to manage in other ways.

• PCNL. Percutaneous nephrolithotomy surgery is performed by direct access into the kidney (keyhole) for patients with extensive stone disease. 

General Stone Prevention Advice

We recommend 5 simple dietary modifications that can significantly reduce your chances of recurrent urinary stones:

1. Increase fluid intake. If you remember one of these recommendations, let it be this one!

2. Avoid excess salt.

3. Avoid excess red meat.

4. Maintain 1-2 serves of dairy a day which includes milk, yoghurt and other dairy products.

5. Enjoy citrus drinks such as orange, lemon or lime juice.

Contact

At Adelaide Urology Care, we are dedicated to giving you the personalized care you need. Please do not hesitate to contact us for more information. 

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Kidney Stones on CT Scan