Procedures For Kidney Stone Removal - An Overview

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What are kidney stones? 

Kidney stones, as the name itself suggests, are stones that form in the kidneys and can be as tiny as a speck of dust, or as big as the size of a tennis ball. Apart from the kidneys, the stones can also form anywhere along the urinary tract which includes the ureter, bladder, and urethra. 

After your body absorbs the nutrition it needs, the remaining waste products travel through the bloodstream to the kidneys. The waste products get removed from your body through urine. When there is too much of waste and too less liquid in the urine, crystals begin to form which stick together and form solid masses or kidney stones.

The common symptoms of kidney stones include:

  • Foul smelling urine
  • Discoloured urine: pink, red, brown urine or blood in the urine
  • Frequent and urgent need to urinate
  • Fever and chills
  • Nausea and vomiting
  • Shifting pain in the lower abdomen and groin
  • Varying intensity of pain that comes and goes

Although the exact causes leading to the formation of the stones have not been established yet, a number of factors have been identified which increases the risk of kidney stones.

Risk factors for kidney stones include:

  • Inadequate consumption of water
  • A family history of kidney stones
  • Being bed-bound due to illness
  • Sedentary lifestyle
  • Obesity
  • Suffering from frequent urinary and kidney infections
  • Eating a high-protein diet and low-fiber diet
  • Consumption of excessive sodium (salt)
  • Active medical conditions such as Crohn's disease, gout, renal tubular acidosis, hyperparathyroidism, medullary sponge kidney, type 2 diabetes, and Dent's disease
  • Excessive consumption of supplements such as calcium and vitamin C


What are the types of kidney stones?

There are four main types of kidney stones:

  • Calcium Stones: Calcium stones are the most common form of kidney stones. They are formed when there is too much calcium in the urine. They may form due to an overactive parathyroid gland, an inherited condition called hypercalciuria, kidney disease, some cancers, or a condition called sarcoidosis.
  • Struvite Stones: These are horn-shaped and can grow quite large. They are usually caused by urinary tract infection.
  • Uric Acid Stones: Uric acid stones are softer than other types of kidney stones. They may occur due to a high-protein low-fibre diet. Patients suffering from gout are found to be at a higher risk to get uric acid stones.
  • Cystine Stones: They are caused by a rare hereditary disorder called cystinuria. Cystine stones are larger than other forms of kidney stones and tend to recur.

In about 85% of the cases, small kidney stones (<5 mm) pass out in the urine without medical intervention. Stones bigger than 5 mm may require medical intervention. Stones as small as 2 mm have been known to cause discomforting symptoms.

What kind of a doctor should I consult for kidney stone removal?

If you experience any of the aforementioned symptoms of kidney stones, you should immediately consult your family doctor or a general physician, who in turn may refer you to a urologist if a kidney stone is suspected.

How are kidney stones diagnosed?

After getting to know your symptoms, medical history and after a complete examination, the urologist will suggest tests to confirm the diagnosis of kidney stones. The tests may include:

  • A computerized tomography (CT) scan – where a computerized low-intensity X-Ray images are taken from different angles and analyzed.  


  • X-ray - which uses a low dose of electromagnetic radiation to accurately create images of the internal structures of your body. Radiolucent stones such as Cystine or uric acid stones may not be identified with this test.
     
  • Ultrasound scan: Images of the internal structures of your body are recreated using high-frequency sound waves.


  • Intravenous urogram (IVU) or intravenous pyelogram (IVP): In this procedure, a radio-opaque dye is injected through a vein in your arm. This dye highlights the presence of the stones on an X-ray. The dye later passes out of your body in the urine. It is advised that you inform the doctor about all your current medicines and allergies before undergoing this procedure. Before administering the dye though, your urologist will make sure that you are not allergic to it.

What are the kidney stone removal procedures? 

The following treatments and procedures are available to manage kidney stones: 


  • Diet: Your doctor/dietician may prescribe you with a modified diet.


  • Medications: Your doctor may prescribe medicines which can dissolve certain types of kidney stones. (ex. kidney stones formed of calcium or uric acid can be treated with medicines.)
    Other medicines are also prescribed to relieve the symptoms of kidney stones which include:

    • pain medicines
    • muscles relaxants which assist the stones to pass through
    • antibiotics to manage any infection
    • Other medications to manage the underlying disease that is causing the kidney stone


What is the cost, anaesthesia type administered, and the success rate of each kidney stone removal procedures? 

To know the:

  • description of kidney stone surgeries
  • cost of kidney stone surgeries
  • anaesthesia type administered for kidney stone surgeries
  • the success rate of each kidney stone removal procedures

please refer to the comparative kidney stone procedures table below: 


What is the recovery time and the time taken to perform each of the kidney stone removal procedures? Is hospitalization required for all procedures? 

To know the:

  • time taken to perform each procedure
  • the recovery time
  • whether it is an inpatient or an outpatient procedure

please see the comparative kidney stone procedures table below:


What is the eligibility criteria for the kidney stone procedures? 

To know the eligibility criteria of each of the kidney stone procedures please refer to the table below:


To know ineligibility criteria for the kidney stone procedures please refer to the table below: 

 

What are the common side effects of the kidney stone procedures?

 Please refer to the comparative table below for the most common side effects of kidney stone removal procedures: 

More Topics on Kidney Stone Removal 

People interested in this topic also read: 

References

1. Madhy S. Agrawal H. Management of multiple/staghorn kidney stones: Open surgery versus PCNL (with or without ESWL). PubMed Central (PMC). 2018.  Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2710093/. Accessed March 5, 2018.

2. Aboumarzouk O, Kata S, Keeley F, McClinton S, Nabi G. People who undergo ureteroscopy for the treatment of stones achieve a higher stoneā€free rate but have more complications and longer hospital stay. 2018. Available at: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0013680/. Accessed March 5, 2018.

3. Zengin K, Tanik S, Karakoyunlu N et al. Retrograde Intrarenal Surgery versus Percutaneous Lithotripsy to Treat Renal Stones 2-3 cm in Diameter. 2018. Available at: https://www.hindawi.com/journals/bmri/2015/914231/. Accessed March 5, 2018.

4. Reddy S, Shaik A. Outcome and complications of percutaneous nephrolithotomy as primary versus secondary procedure for renal calculi. 2018. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4871386/. Accessed March 5, 2018.

5. Younesi Rostami M, Taghipour-Gorgikolai M, Sharifian R. Treatment of Kidney Stones Using Extracorporeal Shock Wave Lithotripsy (ESWL) and Double-J Stent in Infants. 2018. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3329132/. Accessed March 5, 2018. 

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Patient Experiences

Rahul
Effective Lithotripsy Treatment
I am very thankful to Dr shyam varma for taking a special care and giving me a pain free surgery. He has in fact shown me all surgery clips after surgery explaining details. He is definitively one of the best urologist for stone treatment. ...Read Less
Doctor in this story :Dr. Shyam Varma
Pace Hospitals - Best Gastro, Liver & Kidney centre 24x7
Basant Kumar
Successful Kidney Stone Surgery
Hakim Hari Kishan Lal Dawakhana provideds lifetime registration to the patients that save a lot of money. This clinic is highly suitable for enjoying the best treats for any of the sex related issues, whether it is weakness, infection or any other complicated issue....Read Less
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