Urology

Kidney Stone Treatment (A Urologist’s Guide)

Kidney stones are hard deposits made of minerals and salts that form inside the kidneys. They vary in size, from as small as a grain of sand to as large as a golf ball. In Singapore, kidney stones are a common medical condition that affects many people yearly. Seek medical attention if you experience any symptoms of kidney stones, as prompt treatment can prevent complications and help you get back to your normal routine.

Symptoms and Causes of Kidney Stones

The most common symptom of kidney stones is sudden and severe pain in the back or side, which comes and goes in waves. Often, this pain radiates to the lower abdomen and groin. This is known as renal colic. This is due to a kidney stone stuck in the narrow ureter, causing obstruction to urine flow from the kidney. Other symptoms can include nausea and vomiting, blood in the urine, and difficulty passing urine.

Kidney stones are caused by various factors, such as dehydration, a diet high in oxalate, animal protein and salt, and certain medical conditions. Genetics can also play a role in the development of kidney stones.

Diagnosis of Kidney Stones

If you experience symptoms of kidney stones, your urologist will perform a physical exam and take a medical history to determine if your pain is a renal colic Imaging tests, such as X-rays, CT scans, and ultrasounds will be done to confirm the diagnosis.  Blood and urine tests can also be used to detect the presence of kidney stones and to check for any underlying medical conditions.

Non-Invasive and Minimally Invasive Treatment Options

Several non-invasive and minimally invasive treatment options for kidney stones are available, depending on the size and location of the stone.

Extracorporeal Shock Wave Lithotripsy (ESWL)

Extracorporeal Shock Wave Lithotripsy (ESWL) is a non-invasive treatment option for kidney stones that uses shock waves to break up the stones into smaller pieces that can be passed in urine. It involves placing a special machine, called a lithotripter, outside the body and using shock waves to target the kidney stones. ESWL is typically recommended for patients with smaller stones (less than 2cm) located in the kidney or upper ureter.

Advantages and Disadvantages

ESWL is generally safe with minimal risks and side effects associated with the treatment such as bruising and discomfort. However, the success rate may vary, depending on the location of the stone and its size.

Ureteroscopy and Laser Lithotripsy

Ureteroscopy involves using a small scope to remove the stone from the ureter or kidney. The procedure is performed under general anaesthesia and involves inserting a small scope through the urethra and bladder and into the ureter or kidney. Once the scope is in place, the stone is fragmented with laser and the fragments are removed with an endoscopic basket. It’s typically recommended for patients with larger stones or stones that are located in the lower part of the ureter.

Advantages and Disadvantages

Ureteoscopic stone removal is highly effective in removing stones completely. Common side effects include discomfort and blood in the urine.

Percutaneous Nephrolithotomy (PCNL)

Percutaneous Nephrolithotomy (PCNL) is a minimally invasive treatment option for very large kidney stones that cannot be treated with other non-invasive procedures. The procedure involves making a 1cm incision in the back and creating a tract through the skin into the kidney. Through the skin tract, a endoscope is used to break up the stone in the kidney, and the fragments are removed from the kidney. The stone is then broken up into smaller pieces and removed through the incision. PCNL is typically recommended for patients with larger stones (greater than 2cm) located in the kidney. Patients are hospitalised for 2 days in hospital after PCNL and most patients can return to their normal activities within a few weeks after the procedure.

Advantages and Disadvantages

PCNL can be very effective for removing large kidney stones through a small incision. Common side effects include discomfort and blood in the urine, while more serious complications include infections or bleeding.

Conservative Treatment and Prevention

Conservative treatment and prevention of kidney stones may involve a combination of pain management, dietary changes, and medication. Pain management options for kidney stones may include over-the-counter pain relievers, such as ibuprofen or acetaminophen, or prescription pain medication. In some cases, opioids may be prescribed for more severe pain. 

Dietary changes can help prevent the formation of kidney stones. Drinking plenty of water and other fluids can help flush out the kidneys and prevent the build-up of minerals that can lead to stone formation. Avoiding foods high in oxalates, such as spinach, chocolate, and nuts, can also be helpful. Medications may also be used to prevent the formation of kidney stones or to help break up existing stones. Some common medications used for kidney stones include potassium citrate, thiazide diuretics, and allopurinol.

Conclusion

Don’t suffer in silence with the discomfort and complications of kidney stones. If you’re experiencing symptoms, seek medical attention promptly. Speak to us to learn more and receive proper evaluation and treatment from our senior consultant urologist in Singapore. We’ll work with you to determine the best treatment options and provide the care and support you need to alleviate your discomfort and prevent complications.

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