Monthly Archives: February 2014

What are kidney stones, why did I get one and what do I do now?

Kidney Stones in Richmond, VirginiaResearch has shown us that about 15% of adults will develop a kidney stone (renal calculus) in their lifetimes, and we know that this problem has been around for a very long time. Napolean, French King Louis XIV, Isaac Newton and Lyndon Johnson – even Egyptian mummies — all suffered from kidney stones, so you are in good company!

Kidney stones are formed when tiny mineral crystals in the urine start to stick together, forming a hard stone. These are usually very small and pass through the urinary tract with no problem, but occasionally they are large enough to obstruct the flow of urine. When this happens, the pain and other symptoms begin. The hallmark symptom of an obstructing kidney stone is waves of pain in the flank, between the ribcage and the hip bone; if the stone is stuck further down in the ureter, groin and abdominal pain may be present. The pain is sometimes accompanied by nausea and vomiting, fever, blood or pus in the urine and painful urination.

We know that there are a number of causes and risk factors. The most common causes include low fluid intake and high intake of animal proteins, some fruit juices, refined sugars and fructose, and supplemental calcium. Interestingly, dietary calcium (milk and cheese) does not seem to be associated with stone formation. There are other less common causes, and we will work with you to determine the cause and the best course of treatment and prevention.

We diagnose kidney stones using a combination of your history, examination and tests. The “gold standard” is a helical CT scan, which will allow us to see most stones. Standard x-rays will frequently show the presence of stones, as will techniques using dyes. The urine is examined under the microscope to check for crystals, blood or pus, and tests are done to check calcium and other mineral levels in the blood.

Treatments for kidney stones are usually very successful.

Stones smaller than about 1/4″ in diameter will usually pass by themselves and only pain medications are required. Larger stones may require more intervention. If surgery is required, we commonly use minimally-invasive techniques, often with very slender flexible lighted tubes which allow us to see and grab the stone to remove it. If there is significant back-up of urine causing the kidney to swell, a small incision may be made in the flank with insertion of a slender tube to drain the urine and decompress the kidney. A stent, or a very soft slender tube may also be inserted to allow urine to drain from the kidney to the bladder.

Lithotripsy can be used to “blast” stones with ultrasonic waves, causing them to break into smaller pieces, which can then be passed with urine. While there are some potential complications, it can be a safe and effective treatment for some patients.

Regardless of the cause of your kidney stones, we will go over the pros and cons of each treatment with you, considering the kind, size and location of your stone and help you decide which is the best treatment for your individual case. We also look forward to working with you development prevention strategies based on your condition and physiology.

Symptomatic kidney stones can make you feel miserable, but we will do everything we can to make you feel better as soon as possible, and to help you avoid another attack.