Kidney Stones

Most small kidney stones can pass through the urinary system with plenty of water - six to eight glasses a day - to help move the stone along. For larger kidney stones, the following treatment options are available :

Medical Therapy for Kidney Stones

Certain medications may help prevent calcium and uric acid stones by controlling the amount of acid or alkali in the urine which are key factors in crystal formation. The medicine allopurinol may also be useful in some cases of hyperuricosuria where the chemical uric acid is secreted in large amounts in the urine.

Surgical Treatment for Kidney Stones

There are three ways to treat kidney stones using surgery. This includes :

Extracorporeal shock wave lithotripsy (ESWL): You lie on a special machine that produces shock waves. The shock waves are created outside the body and travel through the skin and body tissues until they hit the denser kidney stones. The stones break down into small particles that pass easily through the urinary tract in the urine. ESWL is usually done on an outpatient basis. Recovery time is relatively short, and most people can resume normal activities in a few days. Many people have blood in their urine for a few days after treatment.

Complications may occur with ESWL. Bruising and minor discomfort in the back or abdomen from the shock waves can occur. To reduce the risk of complications, patients are normally told to avoid aspirin and other medicines that affect blood clotting for several weeks before treatment. Sometimes, the shattered stone particles cause a minor blockage of the urinary tract which requires the placement of a stent into the ureter to help the fragments pass. If the kidney stone is not completely shattered with one treatment, additional treatments may be needed.

Percutaneous nephrolithotomy (PCNL): PCNL is often used when the kidney stone is quite large or in a location that does not allow for the eff ective use of ESWL.

In this procedure, the surgeon makes a tiny incision in the back and creates a tunnel directly into the kidney. The surgeon uses a nephroscope to locate and remove the kidney stone. A small tube called a nephrostomy tube is left in the kidney for a few days.

The advantage of percutaneous nephrolithotomy is that some of the kidney stone fragments can be removed directly instead of relying solely on their natural passage from the kidney.

Ureteroscopic stone removal: Ureteroscopy may be needed for mid- and lower-ureter stones. The surgeon passes a ureteroscope, a small fi beroptic instrument, through the urethra and bladder into the ureter to locate and fragment the stone with laser energy and remove it with a cage-like basket. A small stent may be left in the ureter for a few weeks to help urine flow.