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Kidney Stones

Updated: Jan 5, 2020

One of the most common conditions for seeing a urologist is kidney stones. Often patients with kidney stones get to meet a urologist for the first time in the middle on the night in the emergency department while in great distress. Understanding what kidney stones are and how they are made may help avoid this very distressing condition in the first place.



Urine contains many different salts and minerals as well as filtered water. When the concentration of the salts and minerals reach a threshold level in a concentrated medium, then crystals precipitate which turn into kidney stones. Kidney stones are often asymptomatic if they are not obstructing the flow of urine from the kidney to the bladder via the ureter.


Most kidney stones are composed of a calcium base with calcium oxalate being the most common stone overall. Other stones such as uric acid and struvite as well as cysteine stones are also seen at much lower rates.


Ureteral Stone

As mentioned already, stones that are non-obstructing generally do not cause symptoms. As a stone mobilizes into the ureter and blocks the passage of urine it causes swelling of the kidney (hydronephrosis), which often causes tremendous pain. Pain often starts on the affected side in the flank and back and moves lower in the abdomen and eventually into the pelvis as the stone moves down. This also often causes nausea and vomiting. Some women say the pain is worse than childbirth labor pains.


The most common causes for kidney stone formation are low urine volume or dehydration and dietary factors. Low urine volume creates a concentrated environment for the components of kidney stones and allow them to combine more readily. On the other hand, high amounts of calcium and oxalate in your urine may also lead to increased risk of stone formation. Although calcium is a major component of kidney stones, many studies have shown that a reduction in dietary calcium may not affect the amount of calcium in your urine. However, oxalate which is found in many foods and is mainly obtained from your diet does play a major role and can be controlled through life style modifications.


There are also other conditions such as bowel disease (Inflammatory bowel disease, etc.), medications, obesity, and underlying medical conditions that can predispose someone to kidney stone formation.


Kidney stones are often diagnosed via imaging modalities such as CT scans. Once diagnosed and depending on the size, location, and symptoms, your urologist will discuss treatment options. Small stones can often be monitored for a short period and their passage rate may increase by taking certain medication and increasing fluid intake. Surgery may become necessary which could consist of shock wave lithotripsy, ureteroscopy, percutaneous nephrolithotomy, or other open, laparoscopic, or robotic surgical procedures.


Dr. Shakuri-Rad is able to use all of the above modalities to help you with your kidney stones and get back to a normal pain free life as soon as possible. He is also a big proponent of prevention and will review your case to come up with the best treatment regimen to reduce your stone episodes.

 

As always, the information above is meant to be informative and does not replace your physician's recommendations or judgement. Each individual case has to be evaluated carefully to determine the best course of action. Call or use our contact page to request an appointment to further discuss your unique case with Dr. Shakuri-Rad.

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