What is the Best Procedure for Kidney Stone Removal?

Urologists treat kidney stones based on their type, size and location. Smaller kidney stones can pass on their own without treatment. Your urologist may advise you to drink plenty of fluids to help the stone move along your urinary tract. You will be able to pass smaller stones naturally without any treatment other than pain-relieving medication.

For kidney stones that are larger and block your urinary tract or cause unbearable pain, you may need treatment to break down and remove the stones. If you are vomiting and dehydrated, urgent treatment is necessary.

So what is the best procedure for kidney stone removal?

For larger stones causing excruciating pain or that may not pass on their own, surgery is typically the best treatment. There are four surgical procedures your urologist may consider: shockwave lithotripsy, ureteroscopy, percutaneous nephrolithotomy, and robot-assisted surgery. The best surgical procedure for your kidney stones will depend on their type and location.

You will need surgical kidney stone removal if:

  1. You have a lot of pain
  2. You have large stones that cannot pass on their own
  3. Your stones are blocking urine flow out of your kidneys
  4. You have recurrent urinary tract infections due to stones

At St Pete Urology, our urologists are highly trained and experienced in a full range of surgical procedures for removing kidney stones. We conduct minimally-invasive procedures which guarantee faster healing.

The procedure we perform on a patient will depend on the nature and location of the stone, the patient’s overall health, and other factors.

We ensure that you get the best possible care as quickly as possible, from surgery through recovery.

How are the surgical procedures performed?

1. Shock Wave Lithotripsy

Shock wave lithotripsy (SWL) is a procedure in which kidney stones are targeted using sound waves and X-rays. The stones are broken down before they are passed naturally in urine. This non-invasive procedure is used for small to medium-sized kidney stones, usually less than two centimeters in size, softer, and located in the ureter.

During the procedure, you lie on a table and receive medicine to limit pain and discomfort before high-energy shock waves are aimed at the stone from the outside. No cuts are made in your skin as the waves go through and break the stones into smaller pieces. Your urologist may insert a tube in your ureter, called a stent, which will aid in passing the stones. The procedure will take about an hour and you are free to go home the same day. Recovery time for shockwave lithotripsy is relatively short, so you will be able to return to normal activities within a few days.

2. Ureteroscopy

For bigger stones, your urologist may consider ureteroscopy. For this procedure, a small scope, called a ureteroscope, is inserted into the kidney via the bladder. When the stone is in the upper part of the ureter and kidney, your urologist will use a more flexible ureteroscope. If the stones are in the lower portion of the ureter near the bladder, a rigid scope may be used. Ureteroscopy is an outpatient procedure done without incision and under general or spinal anesthesia.

At St Pete Urology, one of the most common surgeries to treat kidney stones is ureteroscopy with Holmium laser lithotripsy. During this procedure, the urologist inserts a narrow, flexible ureteroscope through your urethral opening and passes it through the bladder to reach the stone. The stone is then collected from the location or broken up using a small laser fiber and removed.

3. Percutaneous nephrolithotomy

Percutaneous nephrolithotomy is a minimally-invasive procedure in which a surgeon makes a small incision, usually at the back or side to create a tunnel directly to the kidney to break and remove a large or irregularly shaped stone. Once an incision is made, an optical instrument, called a nephroscope, is inserted through the incision to reach the stone. The stone is broken down into small pieces and drawn out. This procedure is ideal for kidney stones that are big (larger than 2 centimeters), numerous, too dense, or located in a hard-to-reach area in the kidney or ureter. A stent is inserted to help with the excretion of urine as you heal from the surgery. You may need an overnight stay in the hospital after the procedure and can expect to recover in two to four weeks.

4. Robot-assisted stone removal

Kidney stones can also be removed using the da Vinci surgical system, particularly if you were born with a kidney drainage problem (ureteropelvic junction obstruction) or have complicated stones that cannot be removed successfully using other surgical methods.

This robotic surgical system gives urologists a high-resolution and three-dimensional view of small areas. It allows for an increased range of motion and the ability to make more precise incisions, which ensure less scarring. Patients who undergo this procedure recover more quickly and spend fewer days in the hospital, compared to those who have had traditional open surgery.

Why have your kidney stone removal at St Pete Urology?

At St Pete Urology, our urologists frequently treat patients with kidney stones of different types, locations and sizes. We perform hundreds of kidney stone surgeries every year, using mostly minimally invasive and robotic procedures.

Your condition will be managed by specialists who will recommend the best procedure, apply a personalized treatment plan, and deliver top-notch follow-up care. We will see you through your recovery period and monitor your progress to make sure you are in the best of health.

For more information on kidney stone prevention, diagnosis and treatment, visit the St Pete Urology website.

What Foods Are Good For Kidneys?

Kidneys play a significant role in the overall health of the body. They filter out waste products from blood and send them out of the body as waste through urine. The kidneys also balance fluid and electrolyte levels in the body while making hormones that regulate the function of other organs of your body. But to keep your kidneys healthy, you need to watch what you eat and drink because some foods boost the performance of the kidneys while others stress, degrade and damage them.

What foods support healthy kidneys?

Kidney-friendly foods are those that enhance kidney function and protect them from damage. Generally, a good balance of quality protein, calories, vitamins, and minerals are great for the kidneys. Very high dietary levels of some mineral ions such as sodium, potassium, phosphorus and calcium may in the long run endanger your kidneys. Foods linked to heart problems and high blood pressure may put additional pressure on the kidneys.

For healthy kidneys, consider the following:

1. Stay Hydrated

Water helps to flush out toxins from the body. In fact, the body relies on water to assist transporting toxic wastes into the bloodstream, then to the kidneys where they are filtered and removed through urine. This process helps reduce the risk of bacterial infection, kidney stones, and kidney disease, which is why water is crucial for the critical salt-fluid balance in the body.

Ideally, you should drink 6-8 glasses of water per day, but of course you can drink more if you are active during the day. In addition to the many other benefits of staying hydrated, drinking water when thirsty helps to support your kidneys.

2. Apples and mushrooms

Apples are rich in fiber. One of the fibers, called pectin, helps to reduce various risk factors for kidney disease, such as high blood sugar and cholesterol levels. Apples also have anti-inflammatory constituents, prevent constipation, protect against heart disease, and lower the risk of cancer. You might also consider eating mushrooms for their high levels of vitamin D, which boosts kidney function.

3. Sweet potatoes

Sweet potatoes have a robust fiber profile. They break down very slowly in the body which helps to support low insulin levels. Sweet potatoes also have a healthy amount of vitamins and minerals, such as potassium which helps to balance sodium levels in the body and reduce the effect of sodium on the kidneys. However, since they contain high levels of potassium, sweet potatoes are not ideal for those with chronic kidney disease (CKD).

4. Berries

Dark berries, such as strawberries, raspberries and blueberries are a great source of nutrients and antioxidants and for most people protective for the kidneys.

5. Dark leafy vegetables

Leafy vegetables such as kale, spinach and chard contain a wide variety of vitamins, fibers, and minerals that support kidney function. While they do supply a number of protective compounds, dark leafy vegetables are highly rich in potassium and therefore less suitable for those with chronic kidney disease (CKD), restricted diet, or patients on dialysis.

6. Kale and cauliflowers

Kale is a terrific source of vitamins A and C which reduce inflammation, boost the immune system and protect the kidneys. Kale is also lower in potassium compared to other greens, and contains lots of iron. Like kale, cauliflower is rich in vitamin C and also has plenty of fiber and folate that are crucial for kidney function. Likewise, cauliflower contains compounds that improve the liver’s ability to neutralize toxic substances and reduce the stress on the kidneys.

7. Fatty fish and egg whites

Tuna, salmon and other cold-water, fatty fish have high omega-3 fatty acids. The omega-3 fatty acids in these fish are heart protective and also healthy for the kidneys. Since high blood pressure is a risk factor for kidney disease, fatty fish is a great way to improve your cholesterol profile and protect your kidneys.

Foods to avoid include:

1. High salt

Elevated salt levels raise blood pressure making the heart and kidneys work extremely hard. You can control your salt intake by cooking at home and avoiding most fast foods which are sky high in sodium.

You can also try substituting new spices and herbs in place of salt and by avoiding packaged and pre-cooked foods, such as soups, frozen dinners, and boxed meals that usually have extra salt. Similarly, you should avoid table salt and high-sodium seasonings like soy sauce, garlic salt and sea salt.

2. Foods rich in potassium

While potassium helps your nerves and muscles to work properly, too much of it can lead to serious heart problems and eventually to kidney issues. Potassium is found in most fruits and vegetables, such as bananas, oranges, avocadoes, raw carrots, cooked broccoli, potatoes, greens, tomatoes, and melons.

Instead of these high potassium foods, try alternatives such as apples, cranberries, blueberries, raspberries, and strawberries. Other good options are pineapples, peaches, plums, asparagus, cabbage, cucumber, and beans (green and white).

3. Limit phosphorus and calcium

Phosphorus and calcium are great minerals for keeping your bones healthy and strong. But high levels of phosphorus may increase the risk of long-term kidney disease. Since most foods that contain phosphorus are also equally rich in calcium, the body’s levels of the two minerals can be controlled by similar mechanisms.

If your doctor suggests limiting phosphorus, avoid foods such as red meat, dairy products, nuts, fish, most grains, and legumes. Consider replacing these foods with healthy foods that are lower in phosphorus, such as fresh fruits and veggies, rice, corn and fish.

At St Pete Urology, we encourage our patients to take care of their kidneys through healthy behaviors—exercise, drinking plenty of water and eating a balanced diet. We also perform surgeries and treat urination problems such as incontinence, tumors, cysts, growth and stones of the urinary system, as well as problems of the male reproductive system. For more information on kidney disorders and their treatment, visit the St Pete Urology website.

The 5 Best Ways to Prevent Kidney Stones

When certain chemicals become concentrated in urine, they coalesce into crystals. The crystals then grow into larger mineral deposits called kidney stones. Most kidney stones form when calcium combines with either phosphorous or oxalate, but some form from uric acid, a byproduct of protein metabolism. Once formed, kidney stones can make their way through the urinary tract and pass from the body without problems. At other times, a stone will get stuck somewhere, block urine flow and cause intense pain.

Growing concern

Kidney stones are a rising concern. In fact, one in ten people will have kidney stones during their lifetime. Currently, up to 12% of Americans have stones and those who have had one are 50% more likely to get another within the next 10 years if no preventive measures are taken.

The passing of kidney stones is often characterized by agonizing and intolerable pain that comes in waves as the stones move through the urinary tract and out of the body. The pain may occur on one side of your back or abdomen, or it may radiate to your groin and belly area. While the severity of the pain does not necessarily relate to the size of the stone, larger stones tend to be more painful than smaller ones.

What are the 5 best ways to prevent kidney stones?

1. Drink plenty of fluids.

When you pass a lot of urine every day, you have a lower risk of developing kidney stones. The more you urinate, the lower the chance of stone-causing minerals settling and combining in your kidneys and urinary tract. Drink plenty of water to ensure you urinate up to 2 liters of urine daily. You will need roughly eight 8-ounce cups of water to achieve that. Orange juice and lemonade are also good because the citrate they contain helps prevent stone formation.

If have a history of cystine stones, engage in heavy exercise or just sweat a lot, you should drink even more water. Demanding workouts increase water loss through sweating and reduce urine output, so keep your body hydrated during and after exercise. You can tell if you are properly hydrated by the color of your urine. A clear to pale yellow urine means proper hydration while a dark color indicates a need for more fluids.

2. Increase your calcium intake.

Calcium oxalate stones are the most common kidney stones. But that does not mean you should avoid calcium-rich foods—actually the opposite is true. A low-calcium diet increases the risk of stones and osteoporosis. A calcium deficiency allows oxalate levels in urine to rise, triggering the formation of stones.

A good approach is to enhance your daily intake of calcium according your age. For instance, if you are a man 50 years or older, you need 1,000 milligrams (mg) of calcium per day, together with 800 to 1,000 international units (IU) of vitamin D to help with calcium absorption.

Calcium-rich foods include cheese, milk, and yogurt. Avoid calcium supplements as they may increase your risk of kidney stones; however, you can reduce that risk by taking supplements with your meals. It is always a good idea to speak with your doctor when considering supplements and dietary changes.

3. Eat fewer oxalate-rich foods.

Oxalate is a natural compound found in some foods. Since it binds with calcium in urine to form kidney stones, reducing oxalate-rich foods helps prevent stones from forming. Examples of foods rich in oxalate are chocolate, spinach, coffee, peanuts, beets, rhubarb, sweet potatoes, beets and wheat bran. Colas should also be avoided because they are rich in phosphate.

If you have suffered from kidney stones, your doctor may recommend you avoid these foods or consume them in smaller quantities. However, you can also eat oxalate-rich foods alongside calcium-rich foods as an alternative to avoiding them. Calcium and oxalate can bind together to actually reduce the risk of kidney stones.

4. Reduce your sodium intake.

When your diet is high in sodium, the amount of calcium in your urine increases. Sodium prevents calcium re-absorption from urine to blood, which in turn leads to high calcium in urine that may cause kidney stones. Reducing sodium intake lowers the amount of calcium in your urine.

The recommended daily limit of total sodium intake is 2,300 mg. But if sodium has contributed to your kidney stones in the past, you should reduce intake to 1,500 mg per day. Your doctor may advise that lowering sodium benefits your blood pressure as well. It is easier to lower sodium intake by avoiding foods such as:

  • Processed foods, like crackers and chips
  • Canned vegetables
  • Canned soups
  • Condiments
  • Lunch meat
  • Foods containing sodium nitrate, monosodium glutamate, or sodium bicarbonate (baking soda)

5. Limit intake of animal proteins.

Animal proteins not only raise the amount of uric acid in your body, they also increase body acid levels. Increased urine acidity promotes the formation of both uric acid and calcium oxalate stones.

Need help dealing with kidney stones?

St Pete Urology brings together a multidisciplinary team of experts in urology, nephrology and nutrition to offer a single point of care for patients with acute or recurrent kidney stones. We treat kidney stones using the latest minimally-invasive and nonsurgical procedures, including ureteroscopy, extracorporeal shockwave lithotripsy and percutaneous nephrolithotomy. We also have advanced tools such as Holmium lasers and specialized ultrasound and ultrasonic equipment.

At St Pete Urology, we don’t just treat kidney stones. We aim to prevent their recurrence. Our focus is on the overall health of our patients with the goal of making their first kidney stone incident their last. For more information on the prevention, diagnosis and treatment of kidney stones, visit the St Pete Urology website.

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What color is urine when kidneys are failing?

Kidney failure is a condition in which one or both kidneys can no longer work on their own. It may be due to an acute injury to the kidneys or a chronic disease that gradually causes them to stop functioning. When kidneys are healthy, they clean the blood by removing excess fluid, minerals and wastes. But when they are failing, harmful wastes build up in the body and excess fluid is retained, changing the appearance, amount and number of times urine is passed.

Clues from urine color

Urine can provide a lot of information about what is going on in the body, including kidney failure. It can be all sorts of colors, from pale yellow to amber, and even pink, orange or green. For healthy urine, the color ranges from pale yellow to amber-colored, depending on the body’s hydration level. Pale yellow urine means high hydration while dark amber means more concentrated urine, indicating dehydration.

The pigment called urobilin (urochrome) causes the yellow color in urine. The kidney filters out this byproduct from the bloodstream and removes it from the body in urine. The more fluids you drink, the lighter the color of this pigment in urine. The less you drink, the stronger the color. For example, during pregnancy there is 50% increase in blood volume, so urine tends to be clearer and more diluted during pregnancy.

What urine colors are abnormal?

Paying attention to the color of urine can make you aware of your kidney health and alert you to the need for a medical checkup. Clear to yellow urine is normal and indicates normal kidney function, while odd colors such as orange or blue may be due to certain medications such as laxatives, antidepressants and antibiotics. But there are two colors that you must take seriously: red and dark brown.

Pink or red urine means red blood cells are present in urine. These colors may be a sign of infection, kidney stones or even cancer. Dark brown urine could mean you are extremely dehydrated, but if you drink plenty of fluid and the urine is still brown then you may have muscle breakdown, kidney disease or kidney failure.

What is the color of urine when kidneys are failing?

When kidneys are failing, the increased concentration and accumulation of substances in urine lead to a darker color which may be brown, red or purple. The color change is due to abnormal protein or sugar, high levels of red and white blood cells, and high numbers of tube-shaped particles called cellular casts. The presence of blood in urine may make urine appear red or the color of tea or cola. Dark brown urine occurs in kidney failure due to the buildup of waste products in urine or urinating less often and in smaller amounts than usual.

Foaming or fizzing urine may also be a sign of kidney failure, though foam is not a color and usually occurs due to increased protein in urine or kidney disease. Foamy urine indicates a diminished ability of the kidney to filter and clean the blood.

Treatment of kidney failure

Kidney failure can be a debilitating and life threatening condition with symptoms such as lethargy, weakness, generalized swelling, shortness of breath, congestive heart failure and fatal heart rhythm disturbances. If your kidney is failing, treatment of the underlying disease may be the first step in correcting the problem.

Many causes of kidney failure are treatable and visiting a urologist will ensure the underlying condition is diagnosed and treated to restore normal function. The urologist may also plan for control of blood pressure, diabetes or other underlying conditions as a way of preventing chronic kidney disease. But in some situations, kidney failure is progressive and irreversible. When that happens, the only treatment options are dialysis or transplant, each with benefits and drawbacks.

Whatever treatment your urologist recommends, you will need to make some changes in your life, including how you eat and plan your activities. With the help of your urologist, family and friends, you can continue to lead a full and active life. For more information on symptoms, diagnosis, treatment and management of kidney failure, visit the St Pete Urology website.

How does the kidney filter blood?

Many people do not realize how vital their kidneys are to their overall health until an issue arises and they need to seek medical care. Knowing what your kidneys do and how they function can go a long way toward maintaining good health before a problem occurs or understanding the treatment process once you are under a urologist’s supervision.

What Do My Kidneys Do?

Your kidneys are basically your body’s filtration system. Every minute, approximately half a cup of blood flows through them. As the blood flows through, waste products are removed, as is excess water; the levels of minerals and salt are also adjusted if need be. Although around 150 quarts of blood are filtered by your kidneys every day as it continually cycles through your body, only about 1-2 quarts of urine are produced from the waste products and excess water. The urine then flows to the bladder through a tube called the ureter.

How Do My Kidneys Work?

Inside each kidney, there are about a million tiny filtration units called nephrons. The nephrons are made up of a filter called a glomerulus and a tube called a tubule. Blood flows through the glomerulus, where waste and excess water or minerals are filtered out. The tubule then sends the filtered substances to collect in the kidneys before flowing through the ureter to the bladder, while the newly-filtered blood is returned to the rest of the body. There are so many nephrons in your kidneys that even if more than half of them are no longer working, you may not notice any issues or symptoms.

What Happens If Something Goes Wrong?

Many things can occur to interrupt the function of your kidneys. Warning signs of kidney disease include an increased need to urinate, especially at night, blood in the urine, foamy urine, cramping muscles and swollen ankles and feet. These are all signs that something could be wrong with the filtration system in your kidneys, causing issues with fluid and electrolyte levels in your body.

Another common problem is kidney stones. When there is a buildup of certain waste products in the kidneys and not enough fluid to flush them out, these waste products can crystallize and form stones that cause extreme pain as they leave the body. If you suspect you are dealing with kidney stones, kidney disease, or other problems with your urinary system, it’s important to talk to a doctor right away, like the urologists at St Pete Urology, who will be able to diagnose any issues and help you and your kidneys return to normal healthy function as soon as possible.

For more information, visit the St Pete Urology website.

Nephrolithotomy for Treating Kidney Stones

What is nephrolithotomy? The complete surgical procedure name is called percutaneous nephrolithotomy (PNL). It is a procedure used to remove kidney stones. If the stone is too large to go through the tube, the surgical procedure is called percutaneous nephrolithotripsy, because the surgeon must first break the stone into pieces small enough to be removed from the body. So far as the patient is concerned, there are no differences between the two procedures.

PNL is done:

  1. When the stones are stuck in the ureter (which is the urine tube between the kidney and the bladder)
  2. The stones are blocking more than one branch of the kidney’s collecting system
  3. The stones are nearly an inch in diameter (2 cm or larger)
  4. The patient has other types of infections at the same time
  5. When other treatments have failed, such as the use of an external ultrasound lithotripsy (SWL)

PNL requires general anesthesia. The urologist surgeon will make a small incision in the patient’s back, through which a nephroscope tube will be inserted in the patient’s back and into the kidney. The scope tube has a camera and other tools as needed to remove the stone, including a small vacuum.

During that procedure, the doctor will usually place a ureteral stent to prevent certain types of pain for the time of the operation and the first two days afterward while the kidney is healing. A foley catheter also will be inserted to drain the bladder. Another drain will be placed through the surgical incision area to help to directly drain the kidney of urine. Because it takes time for basic healing to take place, the procedure typically requires a three-day inpatient stay.

The risks may include bleeding, temporary holes in the kidney, injury to other organs, such as the bladder or the colon, and other types of damage to normal kidney function. However, PNL has less than a 10 percent recurrence rate for kidney stones, making it one of the most effective approaches for treating them. In rare cases, there may be incomplete stone removal. As with all surgeries, infection may occur.

There will be several follow-up visits to the urologist. Patients usually can be back to work within one or two weeks.

St Pete Urology has the urologists who know how to compassionately work with patients throughout the treatment process. From early diagnosis, through the surgery, and by effective follow-up visits, the patents can know they are in the care of competent urological specialists. For more information, visit the St Pete Urology website.

What Can You Do To Reduce The Risk of Having Kidney Stones

Kidney stones are hard, crystallized minerals that form in the kidneys that may spread to other organs in the urinary tract such as the bladder and the ureter. They form when urine becomes so concentrated with minerals that the minerals crystallize and harden. Often stones are formed from a fusion of calcium and oxalate or phosphorus. Symptoms of kidney stones include trouble passing urine, excruciating pain when passing urine, pain in the groin, below the ribs and in the abdomen, blood in the urine and frequent urination. While reports indicate that the prevalence of kidney stones has grown in modern times, the condition still remains a preventable one.

Ways of preventing Kidney Stones

1. Cut down on sodium intake
A heavy sodium intake causes a proportionate increase in the amount of calcium in urine, creating a good chance of kidney stone formation. Processed and canned foods are known to contain high amounts of sodium. It is advisable to reduce one’s consumption of such foods.

2. Staying hydrated
Drinking enough water and other fluids is one of the best and easiest ways to prevent kidney stones. Water dilutes urine, making it less concentrated. A shortage of fluid in the body translates into just a little concentrated urine. Urine salts are more likely to crystallize and form stones because there is insufficient water to dissolve them.

3. Consumption of foods rich in calcium
Even if most stones have aspects of calcium, calcium rich foods such as milk and cheese prevent the likelihood of kidney stone recurrence. This is because the levels of oxalate, which is a stone forming mineral, increase with decreasing levels of calcium. Calcium should be maintained at a good level.

4. Cut down on the intake of animal proteins and fructose
Organ meats, red meat, seafood and poultry contain a compound known as purine which contributes to the formation of kidney stones, specifically uric acid stones. The same goes for foods with high fructose, with corn syrup specifically being one to avoid. Managing the intake of these foods should go a long way in preventing stones from forming.

In addition to watching one’s diet, medical professionals advise that people should obtain a good amount of exercise to prevent weight related disorders such as obesity.

Kidney stones are very painful and, in this instance, there is no question that prevention is much better than cure. If you discover that you have kidney stones, you should seek medical attention immediately. For those interested in prevention only, reading up on the subject can offer practical ways to avoid having kidney stones. The staff of specialists at St. Pete Urology also are able to help with diagnosis, prevention and treatment of kidney stones. For more information, visit the St Pete Urology website.

How can I prevent recurrent kidney stones

Kidney stones occur when tiny crystals form and stick together as solid masses in urine. Often, due to increased concentration of various chemicals in urine, crystals form and then grow into larger masses that move through the urinary tract. As they move, the stones may get stuck somewhere along the tract and block urine flow, causing pain. Most kidney stones are a combination of calcium with either oxalate or phosphate, but stones also may form when uric acid levels increase in urine as a result of protein metabolism.

Preventing kidney stone recurrence

For many people who have had a kidney stone, it is not a one-time thing. In fact, in about 50 percent of those who have had a stone, another one will appear within 7 years if no preventive measures are in place. At St Pete Urology, we ensure that our patients take the necessary steps to prevent a recurrence. That is why, after treatment, we conduct a special urine test on our patients to find out why the stone formed in the first place. Using the results of the test, we guide our patients on how best they can avoid a recurrence.

Some of the measures we recommend to avert kidney stone recurrence include:

1. Drinking enough water

Water dilutes urine, reduces the concentration of substances in it and prevents kidney stones. To prevent recurrent kidney stones, you should endeavor to drink enough fluid to pass at least 2 liters of urine per day. Increased fluid intake that is distributed throughout the day decreases kidney stone recurrence by about 50 percent and with virtually no adverse effects.

For better results, you may add orange juice or lemonade to the water so there is increased citrate in the fluid to block stone formation. Medication such as allopurinol, citrate or a thiazide diuretic can be taken with the fluid to minimize the chance of kidney stone recurrence. However, if you are already drinking that much fluid before your kidney stones, you should not increase your fluid intake.

2. Making dietary changes

Once you are treated for kidney stones, we will recommend that you reduce your intake of eggs, seafood, poultry, red meat and other animal protein. These foods increase uric acid levels while also reducing citrate levels in the body, which can trigger a recurrence of kidney stones. That is why after treatment for kidney stones, we recommend that you should cut down your daily meat portions to a size no larger than a pack of playing cards. Likewise, you should avoid foods such as chocolate, strawberries, wheat bran, beets, spinach, tea, rhubarb and most nuts that contain oxalate or the phosphate containing colas that may trigger kidney stone recurrence.

3. Increasing calcium intake

Oxalate levels may rise and trigger kidney stones if the level of calcium in the diet is low. So after treatment, it is important to ensure that you increase your calcium intake to match your age. For example, if you are a man 50 and older, you should get 1,000 milligrams of calcium every day, together with 800-1000 IU (international units) of vitamin-D to ensure your body absorbs the calcium properly. With increased dietary calcium, you can prevent a recurrence of kidney stones.

4. Reduced sodium intake

Kidney stones may recur if there is a lot of sodium in your diet because increased sodium leads to high concentration of calcium in urine. So after treatment for kidney stones, we usually recommend that you lower the amount of sodium in your diet, limiting your total daily sodium to 2,300 mg. But if sodium was responsible for your previous kidney stones, then we recommend that you should take at most 1,500 mg of sodium per day. Such a low level of sodium also will be good for your heart and your blood pressure.

Those are some of our most common recommendations for averting kidney stone recurrence. As you might have noticed, they are not complicated things to do, but they do require some commitment. For more information on prevention and treatment of kidney stones, visit the “St Pete Urology” site.

3 Effective Minimally Invasive Surgical Treatment For Kidney Stones

Over the last 15 years, kidney stone prevalence has doubled in United States. Today, roughly 1-in-10 Americans will have a kidney stone attack at some point during their lifetime. When they occur, kidney stones can cause agonizing and unbearable pain in the back and side, and may sometimes trigger nausea and vomiting. You can pass a stone by drinking plenty of water — taking pain medications to control the discomfort as you wait for the stone to pass. But if you have a large stone or one that’s causing complications, then a more extensive treatment may be necessary to remove the stone.

Minimally-invasive surgical treatments

At St Pete Urology, we offer surgical treatment for kidney stones, focusing on minimally-invasive procedures even for the largest stones. Most operations for smaller stones can be done as same-day surgeries, giving patients greater flexibility and a faster return to their work and other routine activities. For larger stones, the planning and execution of the procedures may take a little more time, but with the use of small incisions only large enough to allow insertion of thin tubes, fiber-optic lights, cameras and other tiny surgical tools, we are able to ensure significantly less pain, less scarring, shorter hospital stay, faster recovery and increased accuracy than with traditional open surgery for the stones.

There are three main minimally-invasive techniques for removal of kidney stones. The least invasive being extracorporeal shockwave lithotripsy, followed by ureteroscopy then lastly percutaneous nephrolithotomy. The choice of a surgical technique depends on multiple factors, including the type of stone, size and location, medications taken by the patient, other medical problems the patient may have, and patient preferences.

Extracorporeal Shockwave Lithotripsy (ESWL)

This is the most popular option for treating small and medium-sized stones. Performed in an outpatient setting with the patient placed under general anesthesia, ESWL is the least invasive and takes 20-30 minutes to be completed. During the surgical procedure, intense sound waves are focused on the kidney stone, shattering the stone with minimal effect on surrounding tissue. Smaller pieces of stones that are produced get washed out of the urinary system with the normal flow of urine, often with slight or no discomfort. ESWL is a highly effective treatment for most stones that form in the kidney or ureter.

Advantages of ESWL include:

  1. It’s an outpatient procedure so patients return home after a few hours.
  2. It offers excellent success rate with most small-sized and medium-sized stones.
  3. It doesn’t require incisions or invasive techniques.
  4. It has minimal postoperative discomfort.
  5. It has a fast and easy scheduling.

Limitations of ESWL include:

  1. It’s ineffective for stones that are very hard or resistant to breakage by shockwaves.
  2. It’s not appropriate for stones that are invisible on X-ray such as uric acid, monohydrate and cystine stones.
  3. It’s not ideal for larger stones or those located in the lower part of the urinary tract.
  4. It’s not appropriate for patients with certain conditions or using certain medications, such as pregnant women or patients on blood thinning medications.


Ureteroscopy is another surgical procedure often used to treat small and medium-sized stones. The advantage it offers over ESWL is that it can treat kidney stones occurring in any part of the urinary tract. It’s a same-day procedure done after the patient is placed under general anesthesia. The procedure involves passing a small scope via the urinary opening and into the bladder then into the ureter. Once the stone is reached, it is targeted with laser so that it’s broken down into smaller pieces that are extracted out of the system or into pieces of dust left to wash out with normal urine.

Ureteroscopy is a little bit more invasive than ESWL, but it’s preferred in situations where kidney stones are too hard to respond to ESWL, or for stones that are invisible on X-ray. Ureteroscopy is also a better choice than ESWL when stones are located in the lower portion of the urinary tract, especially the region near the bladder. After the procedure, a small tube — a stent — is temporarily placed into the urinary system to help drain the kidney. The stent is totally internal, and is usually removed 3-10 days after the procedure. Stent removal is a quick and easy process done in the doctor’s office and without anesthesia.

Advantages of ureteroscopy are:

  1. Great results for small-sized and medium-sized stones.
  2. It’s an outpatient procedure.
  3. No incisions are necessary.
  4. Fast and easy scheduling.
  5. Done without stopping the use of blood-thinning medications.
  6. Effective for stones that are resistant to ESWL.

Limitations of ureteroscopy are:

  1. It’s not effective for very large stones.
  2. In some rare instances, scopes may not reach the stones.
  3. Many patients find the stents placed after the procedure a source of unease and discomfort.

Percutaneous Nephrolithotomy (PCNL)

For kidney stones that are exceptionally large, complex or several small stones bundled in one kidney, percutaneous nephrolithotomy (PCNL) is the most appropriate treatment. Conducted by a urologist, often assisted by an interventional radiologist, PCNL is typically an inpatient procedure requiring an overnight hospital stay. During the procedure, the urologist and radiologist collaborate to open a direct channel into the kidney’s drainage system via a small incision made in the back, often not larger than a dime.

After making the incision, the urologist uses a set of specialized tools to break the stones into pieces, which are then plucked out or vacuumed out of the kidney. With the procedure completed, a drainage stent or tube is left in place for temporary drainage of the kidney. For stones that are unusually large or complicated, the urologist may schedule a second “clean-up” surgery. In most cases, patients leave the hospital after PCNL within 24 hours of the procedure. And despite PCNL being a more invasive procedure than ureteroscopy and ESWL, it remains an effective and safe treatment that sees a high level of patient satisfaction.

Advantages of PCNL are:

  1. It is the gold standard treatment for very large or really complex stones.
  2. It is the most appropriate surgery for patients with a number of small stones bundled in one kidney.
  3. It clears most kidney stones fully in one procedure.
  4. It is highly safe and effective.

Limitations of PCNL are:

  1. A drainage tube or stent is necessary after the procedure, which may be uncomfortable for most patients.
  2. It is not appropriate for patients on blood-thinning medications.
  3. It is more invasive and so an overnight stay in hospital is a necessity.
  4. Though it clears most stones in one procedure, a repeat procedure may be necessary for the largest or most complex stones.

At St Pete Urology, we perform hundreds of minimally-invasive surgeries for kidney stones every year. We have several surgeons with extensive training, skill and experience in ESWL, ureteroscopy and PCNL, delivering excellent outcomes even for the most difficult kidney stones. Our collaborative, compassionate and patient-centered approach to care also means our patients enjoy utmost comfort and convenience throughout their procedures. So if you have symptoms of what you suspect to be kidney stones, don’t hesitate to come see us. We fix kidney stones safely and effectively. For more information on the prevention, diagnosis and treatment of kidney stones, visit the “St Pete Urology” site.

How To Treat Kidney Stones?

When certain minerals are in excess in the body, they accumulate in urine. The urine becomes more concentrated as the levels of minerals and salts increase, particularly when the body is not well hydrated. As a result, hard masses of minerals and salts called kidney stones — often made of uric acid or calcium — form inside the kidney and can travel to other areas of the urinary tract. About 1-in-11 Americans will have a kidney stone at some point in their lifetime, but stones occur more often in men, people with diabetes and those who are obese.

Stones come in different sizes

Kidney stones vary in size. While some may be as small as a fraction of an inch and others only a few inches across, some stones can be very large and may take up the whole kidney. Smaller stones tend to remain in the kidney and rarely cause pain as they pass out of the body. In most cases they are not noticed until the kidney stones pass into the ureter. But larger stones may block urine flow, cause pain and result in urinary tract problems. Fortunately, the stones rarely cause permanent damage, and there are effective treatments for them.

Pain due to kidney stones

Pain is the most common characteristic and frequent symptom of kidney stones. Although the pain associated with stones varies from person to person, it can be quite intense and agonizing when it occurs — accounting for over 1 million visits to the emergency room every year. Many women who have had the condition attest that the pain is worse than the cramps and spasms of childbirth; others say it’s like being stabbed with a knife. The pain is felt along the side and back and below the ribs, though it may radiate to the belly and groin area with the movement of the stone along the urinary tract. It also generally occurs in waves, each wave lasting a few minutes, before disappearing and coming back.

Treatment of kidney stones

At St Pete Urology, we admit many patients in our emergency department because of painful kidney stones. Some patients also present with symptoms such as nausea, vomiting and hematuria (blood in urine). We determine how to manage kidney stone disease depending on the location and severity of the stones. For patients with small stones — several millimeters in size — we may allow time for the stones to pass without intervention. In that case, a patient is given pain medication, advised to drink plenty of water and waits for the stones to pass, under our close observation. But for large stones or complex ones causing problems such as severe pain, infection or kidney failure, we usually intervene to remove the stones.

Types of treatments

We often intervene to remove kidney stones that fail to pass spontaneously, are affecting kidney function, are accompanied by too much pain to wait for their passage, are blocking the flow of urine or are causing repeated infections. The interventions involve tiny or no incisions, minimal pain and a short time off work. At St Pete Urology, the treatments we commonly provide for kidney stones are extracorporeal shockwave lithotripsy, percutaneous nephrolithotomy and ureteroscopy.

1. Extracorporeal Shockwave Lithotripsy (ESWL)

ESWL (Extracorporeal Shockwave Lithotripsy) is the use of highly-focused sound waves released and focused from outside the body to crush kidney stones. The intense waves are able to reduce the stones into sand-like granules that can pass normally in urine over a few weeks. Before ESWL, patients are given a sedative or placed under regional or general anesthesia and ultrasound or X-rays used to pinpoint the location of the stones.

The procedure takes about 1 hour, but larger or more complex stones may need several ESWL treatments. Patients return home the same day and are able to resume normal activities in 2-3 days. Shockwave lithotripsy is not used for hard stones, such as cystine, struvite, and some types of calcium phosphate and calcium oxalate stones. It’s also not ideal for stones larger than 1 inch in diameter and for pregnant women.

2. Ureteroscopy (URS)

For some kidney stones, especially those located in the kidney and ureter, ureteroscopy is the preferred treatment. The treatment involves passing a small fiber-optic instrument called ureteroscope into the urethra and bladder, then into the ureter. The telescopic instrument enables the urologist to see the stone and to use a small, basket-like device to pull out a smaller stone. For larger stones that can’t be removed in one piece, the urologist uses laser or a similar stone-breaking tool to shatter the stone into smaller pieces.

Flexible ureteroscopes are used for stones located in the kidney and upper ureter while rigid ones are used when stones are located in the lower ureter near the bladder. During the procedure, you are placed under general anesthesia to keep you comfortable. A stent (or small tube) is left in the ureter to keep it open and drain urine from the kidney and into the bladder, but it’s completely within your body and doesn’t require an external urine collection bag. You can return home the same day and resume normal activities in 2-3 days, but the stent must be removed in 4-10 days to avoid infection and potential loss of kidney function.

3. Percutaneous nephrolithotomy (PCNL)

Percutaneous nephrolithotomy (PCNL) is the most appropriate treatment for larger or more complex kidney stones. It’s also the best treatment if several small stones are bundled up in one kidney. During the procedure, the surgeon makes a half-inch incision in the side or back and then guides a nephroscope (rigid telescope) through the incision and into the area of the kidney where the stone is located. Using the nephroscope, the urologist reaches the stone with instruments that fragments it into pieces that are then suctioned out. The ability to suction tiny pieces of stone from the urinary tract makes PCNL the best treatment option for larger stones.

PCNL is performed with the patient under general anesthesia. The procedure requires hospitalization and you are discharged after 24 hours but resume normal activities after 1-2 weeks. Usually at the end of the procedure a tube is placed in the kidney to help drain urine into a bag outside the body. The tube remains for a few days or just overnight. Before you are discharged from hospital, the urologist may do X-rays to check if any pieces of stone remain. The nephroscope may be inserted again if any stone fragments are detected to remove the leftover fragments and to make sure you are completely free of the condition.

At St Pete Urology, we have experienced urologists, specialized equipment and highly-skilled support personnel to help us deliver excellent outcomes for patients with kidney stones. We use both surgical and non-surgical methods to tackle this painful condition, including the minimally-invasive procedures of shockwave lithotripsy, percutaneous nephrolithotomy and ureteroscopy, robotic surgical procedures, advanced imaging technology, medications and dietary changes. For us, the goal is not only to cure kidney stones but also to prevent a recurrence — striving to make your first stone surgery your last. So if you have symptoms of kidney stones or want advice on how to avoid this painful condition, come see us for help. For more information on prevention, diagnosis and treatment of kidney stones, visit the “St Pete Urology” site.