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Kidney Stones

Urolithiasis is the process of forming stones in the kidney, bladder, and/or urethra (urinary tract). Kidney stones are a common cause of blood in the urine and pain in the abdomen, flank or groin. Kidney stones occur in 1 in 20 people at some time in their life. Stone disease is among the most painful and prevalent urological disorders. There are many different types of urinary stones, but calcium-based stones are by far the most common.

Although historically urinary stones were more common in men, recent studies have suggested a rise in the number of women with urolithiasis.

Stones in the kidney often do not cause any signs and can go undiagnosed. When a stone leaves the kidney, it travels to the bladder through the ureter. Often the stone can become lodged in the ureter. When the stone blocks the flow of urine out of the kidney, it can cause the kidney to swell (hydronephrosis), often causing a lot of pain, nausea and vomiting.

Common symptoms of kidney stones are:

  • A sharp, cramping pain in the back and side, often moving to the lower abdomen or groin. Some women say the pain is worse than childbirth labor pains. The pain often starts suddenly and comes in waves. It can come and go as the body tries to get rid of the stone.
  • A feeling of intense need to urinate.
  • Urinating more often or a burning feeling during urination.
  • Urine that is dark or red due to blood. Sometimes urine has only small amounts of red blood cells that can’t be seen with the naked eye.
  • Nausea and vomiting.
  • Men may feel pain at the tip of the penis.

How are kidney stones treated?

Treatment depends on the type of stone, the location of the stone, the size of the stone and the patient’s clinical signs and symptoms.

Passing a stone

Small stones in the ureter can often pass without any treatment. The smaller the stone, the more likely it will pass. If you have a small stone in your ureter (the tube that connects your kidney to your bladder) and your pain is controlled without any signs of infection, you may be a candidate for trial of passage. This typically consists of staying hydrated at home and possibly taking a medication called Tamsulosin (Flomax) which may help passage of distal ureteral stones. You may need pain medication when there is discomfort.

Waiting up to 4–6 weeks for the stone to pass is safe as long as:

  • The pain is bearable
  • There are no signs of infection
  • The kidney is not completely blocked
  • Td the stone is small enough that it is likely to pass

You will be given a strainer to void into so you can catch your stone if you pass it. If you pass your stone, please notify your provider. Typically, you will see a provided back in the office within four weeks with a kidney ultrasound and X-ray to see if the stone has passed. Sometimes your pain can go away but the stone may still be present. If the stone has not passed, surgical treatment of that stone may be recommended.

Surgery options

Surgery may be needed to remove a stone from your kidney or ureter if:

  • Your stone does not pass during a trial of passage.
  • Your pain is unbearable.
  • You are having nausea or vomiting and cannot stay hydrated.
  • The stone is affecting kidney function.
  • Electively chosen to treat the stone.

Today, stone surgery is minimally invasive and usually involves small or no incisions, minor pain and minimal time off from work.

Surgery options include

Preventing kidney stones

Prevention of future stones is a critical part of the care of patients with urolithiasis. Metabolic evaluations can be performed that dramatically decrease a person’s risk of subsequent stones. General recommendations for stone prevention include: 

  • Increasing fluid intake to more than 2 liters/day.
  • Increasing the intake of citrate-containing fluids (such as lemonade and orange juice).
  • Avoiding high sodium intake.