How Are Kidney Stones Formed?

Kidney stones are hard mineral or salt deposits formed in the kidney when urine is concentrated. Originating as microscopic crystals or particles that develop over time into pebble-sized calculi or larger deposits as minerals crystallize and fuse together, kidney stones can affect any section of the urinary tract (the kidney, bladder, ureters and urethra). The kidneys filter and remove wastes from blood, add them in urine and concentrate the urine as it flows from the cortex into the renal pelvis. However, if the minerals and other wastes fail to dissolve completely in urine, microscopic particles may develop which may grow into larger stones.

Why Stones Form

Formation of urine crystals is a common occurrence even in those who never form stones. The natural existence of substances promoting crystal development in all urine means that everyone can have urine crystals. Substances that promote crystal development in urine include oxalate,calcium, phosphorus, uric acid, sodium and cystine (for those with cystinuria). Nevertheless, urine also has natural inhibitors of crystal formation such as magnesium, citrate, phytate, pyrophosphate, proteins, total urine volume and other byproducts of normal metabolism. These inhibitors promote elimination of crystals before they can attach to the kidney and develop into larger stones.

How are kidney stones formed?

Kidney stones typically form from soluble salts found in urine. For example, the soluble salt calcium oxalate is commonly found in urine in a dissolved or crystalline form. Soluble salts are usually formed when various chemical elements found in urine combine. When the urine concentration of these soluble salts is very high, solid crystals may be formed. While there is usually a high concentration of salts in urine, the presence of inhibitors makes it more difficult for crystals to develop.Therefore, urine must become supersaturated for the balance between stone-promoters and inhibitors to be broken and allow larger stones to form. Supersaturation of urine may be caused by low urine volume, very low quantities of inhibitors or very high concentration of stone-promoters.

Processes of stone formation

Kidney stone formation begins by the process of nucleation, an association of free ions into microscopic particles. Nucleation can occur in the kidney nephron and on the surfaces of the extracellular matrix and cells. Once tiny crystals are formed, they can undergo secondary nucleation or aggregation, the processes through which the crystals formed in solution form into bigger multi-component particles. Larger crystals then can grow into giant single crystals which can be retained in the kidney by further aggregation and attachment to specific intra-renal structures.

Passing kidney stones

Once kidney stones are formed, they move down the urinary tract from the kidneys through the ureter and to the bladder. Small stones can pass out on their own without causing problems. However, larger stones can become lodged in the ureter and cause severe, agonizing pain that starts in the lower back and spreads out to the groin. When a stone is lodged in the ureter, it can block urine flow, causing increased pressure build-up in the affected ureter or kidney and resulting in severe pain and spasms. Larger kidney stones (called starghorn stones) also may be problematic to the entire urinary tract, resulting in symptoms such as:

  1. Severe pain in the back, in the side or below the ribs.
  2. Excruciating pain radiating to the groin and lower abdomen.
  3. Red, pink or brown urine.
  4. Pain when urinating.
  5. Pain that fluctuates in intensity or comes in waves.
  6. Frequent urination, urinating small amounts or persistent urge to pass urine.
  7. Nausea and vomiting.
  8. Foul-smelling or cloudy urine.
  9. Chills and fever if an infection is present.

While kidney stones can cause severe pain and discomfort, they usually do not cause permanent damage when recognized early and treated promptly. In fact, depending on the situation, passing the stones may require nothing more than just taking pain medication and drinking plenty of water. In situations where the stones are lodged, obstructive or linked with urinary infections or complications, other removal mechanisms may be necessary, including surgery. The urologist also may recommend effective preventive measures to minimize the risk of recurrent stones.

At St Pete Urology, we have made a difference in many lives by helping patients get relief from the pain and discomfort caused by kidney stones. We have assembled a skilled and experienced team of urologists committed to the best practices in health care and delivering world-class urological care to all. We also have put together the latest diagnostic and treatment tools to ensure that our patients receive the very best care. With our patient-centered, collaborative approach to management of kidney stones and other urological problems, you can be sure that you will not leave our doors without getting the relief you seek.

For more information on prevention, diagnosis and treatment of kidney stones, visit the “St Pete Urology” site.

What do you do for a kidney stone?

Kidney stones can be treated in a number of ways, depending on the cause, size and location of the stones. The treatment and management of kidney stones also depend on your overall comfort level, any complications related to the stones and on your other medical problems. Most kidney stones are small (4mm or less in diameter) and can be passed in urine with the help of medications. The medications are used to keep you comfortable as the stones pass naturally through your urinary tract, with the passage of a stone taking a few days to a few weeks. Larger kidney stones are associated with severe symptoms and may not pass without a medical expulsive procedure.

What should you do with small kidney stones?

Most small kidney stones (4mm or less in diameter) can pass through the urinary tract and out of the body without invasive treatment. To pass such a small stone, you should:

  1. Drink plenty of water: Drinking 2-3 liters of water every day will help to flush out a kidney stone. Unless your doctor says otherwise, make sure to increase your daily fluid intake (mostly water) to increase the rate of passage of any stones you may have.
  2. Use pain relievers: As a kidney stone passes through your urinary tract, it will cause some discomfort. For mild pain, your doctor may recommend over-the-counter medications such as ibuprofen, acetaminophen or naproxen sodium. For severe pain, Ketorolac or narcotics may be recommended.
  3. Medications to increase passage rate: To reduce the time required to pass a kidney stone naturally, your urologist may prescribe medications called alpha blockers (such as tamsulosin) or calcium channel blockers (such as nifedipine) to relax ureter muscles and help you to pass the kidney stone quickly and with minimal pain.

What should you do with larger kidney stones?

Larger kidney stones cannot be treated effectively with conservative measures. Likewise, a kidney stone that is lodged in an area of the urinary tract or that has moved into the ureter and is causing severe pain, bleeding or urinary tract infections may require more extensive treatment. When diagnosed with such a kidney stone, the doctor will recommend that you be admitted to hospital for treatment.

Extensive medical treatment is generally necessary if:

  1. You have a higher risk of kidney failure, especially if you have only one kidney.
  2. Your symptoms are not improving within an hour after taking painkillers or anti-nausea medication.
  3. You are pregnant.
  4. You are dehydrated and vomiting too much fluid.
  5. You are over 60 years of age.

Larger kidney stones (6mm in diameter or more) usually require treatment to remove them. The methods used to remove such stones include extracorporeal shock wave lithotripsy (ESWL), ureteroscopy, percutaneous nephrolithotomy and open surgery. The type of treatment given will depend on the size and location of the stone.

Types of Treatment

1. Extracorporeal shock wave lithotripsy (ESWL)

This is the most commonly used method of removing kidney stones that cannot be passed in urine. The procedure involves application of ultrasound (high frequency sound waves) to identify the location of a stone with more precision. Ultrasound shock waves are then directed at the stone from a machine, breaking down the stone into smaller pieces that can easily pass in urine. ESWL is an uncomfortable procedure and is therefore performed under painkilling medication. More than one session may be necessary for the procedure to successfully treat kidney stones, but ESWL is known to have up to 99 percent efficacy for stones of 20mm or less in diameter.

2. Ureteroscopy

For kidney stones that are stuck in the ureter, the urologist may have to use a ureteroscope (a long, thin telescope) to reach and remove the stones. The thin lighted tube is fitted with a camera to help pinpoint the location of a stone with utmost precision. During the procedure, the ureteroscope is passed through the urethra and bladder into the ureter and to the place where the stone is stuck.
Once the stone is reached, it can be snared or broken down into smaller pieces using laser energy so that the pieces can then pass naturally in urine. Or the doctor may use another instrument to remove the stone without breaking it. Since ureteroscopy is performed under general anesthesia, you will not be able to drive or operate machinery for up to 48 hours after the procedure. Ureteroscopy is highly effective for stones 15mm or less in diameter, but a plastic tube known as stent may be inserted temporarily into your bladder to help drain stone fragments.

3. Percutaneous nephrolithotomy (PCNL)

PCNL is an alternative procedure that is effective for larger kidney stones. It can be used when ESWL is not suitable, such as when the person being treated is obese. Percutaneous nephrolithotomy involves using a thin telescopic device called a nephroscope. The doctor performs the procedure by making a small incision at the back and then passes the nephroscope through the hole into the kidney. Using the nephroscope, the stone is either pulled out or broken down into smaller pieces using pneumatic or laser energy. The procedure is performed under general anesthesia and is 86 percent effective for kidney stones that are 21-30mm in diameter.

4. Open surgery

Nowadays, the use of open surgery for kidney stones is very rare and only performed in less than 1 percent of cases. In fact, open surgery is only recommended when a kidney stone is extremely large or when there is abnormal anatomy in the affected section of the urinary tract. For instance, open surgery may be necessary if the kidney stones (such as calcium phosphate stones) are caused by an overactive parathyroid gland (hyperthyroidism). Removing a tumor that is causing the parathyroid glands to produce excess parathyroid hormone and hence increased calcium levels in the body also may be necessary to treat some kidney stones. During open surgery, the urologist makes an incision in your back and uses the incision to reach the ureter, bladder and kidney. The stone is then removed from its location.

Preventing future kidney stones

After your kidney stones are treated, the doctor will assess your risk of kidney stones and recommend preventive measures. Generally, the formation of kidney stones is prevented using a combination of lifestyle changes and medications.

1. Lifestyle changes

Lifestyle changes that reduce the risk of kidney stones include:
(a) Drinking plenty of water throughout the day: If you have a history of kidney stones, drinking plenty of water (2-3 liters per day) will significantly reduce your risk of having stones in future. You may have to drink even more water if you live in a hot and dry climate. To know that you are drinking enough water, check if your urine is light and clear.
(b) Reduce the quantity of oxalate-rich foods: If you have previously suffered from calcium oxalate stones, then you can reduce your risk of stones in future by scaling down your consumption of foods rich in oxalates. You may have to cut down on your intake of spinach, sweet potatoes, tea, nuts, okra, beets, rhubarb, Swiss chard, soy products and black pepper.
(c) Reduce amount of salt and animal protein in your diet: To avoid kidney stones in future, reduce your salt intake and minimize animal protein in our diet. It is advisable that you use a salt substitute (such as Mrs. Dash) and take non-animal proteins (such as legumes).
(d) Use calcium supplements with caution: Calcium-rich foods will not increase your risk of kidney stones so you can continue eating them unless your doctor says otherwise. However, calcium supplements can increase the risk of kidney stones and should be taken with caution and only after speaking with a doctor or a dietitian.

2. Medications

Certain medications are effective in controlling the quantity of salts and minerals in urine and hence helpful in preventing the formation of stones. However, the type and effectiveness of such medications depend on the type of stone you are have. For calcium stones, thiazide diuretics and phosphate-containing preparations are effective. Allopunirol and alkalizing agents are effective for uric acid stones, small doses of antibiotics can eliminate bacteria and prevent struvite stones, while cystine-reducing medications can prevent cystine stones.
At St Pete Urology, we have established an integrated and multidisciplinary diagnosis, treatment and management program for kidney stones. By bringing together a diverse team of professionals including urologists, nephrologists, clinical nurse specialists, radiologists, nutritionists and other healthcare specialists, we ensure that our patients receive the most compassionate, comprehensive and effective treatment. We offer both surgical and non-surgical treatments with very high success rates. For more help and information on the treatment of kidney stones, visit St Pete Urology’s website.

Diet Suggestions for Kidney Disease Patients on Thanksgiving Day

As Americans across the country get together with family and friends every fourth Thursday in November to give thanks for all that is good in their lives, most kidney disease patients do so while mindful of their health. And since Thanksgiving Day is also full of food, from turkey to potatoes and to various juices, kidney disease patients are all too aware of the potential damage that holiday foods can have on their lives, including worsening their symptoms. For instance, the holiday fare may be full of salted foods, increasing the level of sodium in the body beyond the limits for kidney patients.

To enjoy Turkey Day to the fullest, kidney disease patients such as those with kidney stones have to look for kidney-friendly foods. Observing certain diet restrictions can ensure that they enjoy themselves without harm to their kidney functions or making their illness worse. So what should you eat or not eat on Thanksgiving Day if you have renal problem?

Generally, the diet principles for kidney patients are high-fiber, high-vitamin, low-salt, low-potassium, low-protein, low-fat and low-phosphorous. Here are some suggestions that can help kidney patients enjoy themselves on Thanksgiving Day without worsening their symptoms or harming their kidney functions.

1. Popular dishes

Turkey is the most common food on Thanksgiving Day but renal patients should opt for natural fresh or frozen turkey. The turkey should be prepared with low-salt broth and salt-free rub. Basted turkey which typically contains too much salt must be avoided. Other popular dishes include green beans, sweet potatoes, celery, parsley, cauliflower and cranberry, which are all good foods for renal patients. However, sweet potato contains a lot of potassium, so its intake should be limited. Pecan pie, apple pie and pumpkin pie are popular and delicious Thanksgiving desserts, but renal patients should minimize their intake.

2. Best drinks

Pure water is the ideal drink for renal patients on Thanksgiving Day. However, those who do not want to drink water can have apple juice and cranberry juice. If you are experiencing fluid retention, often characterized by swelling and edema, then reduce the amount of fluid you take. Avoid alcoholic beverages because too much alcohol can damage your liver and elevate your blood pressure. Likewise, drinks containing caffeine such as strong tea and coffee should be avoided.

3. Increase your calcium, fiber and vitamin intake

If possible, increase the amount of fiber, vitamin and calcium in your Thanksgiving diet because they are good for your health. However, you should limit the intake of excitant and spicy foods and avoid high-fat foods such as spicy chicken wings. Also reduce the quantity of meat in your diet as it may increase your kidney’s burden and elevate your BUN and creatinine levels.

4. Avoid salted foods

Salt contains high quantity of sodium, which is harmful for the kidney. For instance, high quantities of sodium in the diet elevate blood pressure and trigger fluid retention, which is a very common problem in people with kidney disease. Therefore, if you have kidney disease you should avoid salted foods on Thanksgiving Day.

5. Pay attention to your protein intake

For those with early-stage kidney disease, protein intake should be limited to 0.6-0.8 gram per kilogram body weight per day. But if the disease has advanced, the protein intake must be reduced significantly to just 0.2-0.4 g/kg/d. For patients on dialysis, protein intake should be increased to 1.2 g/kg/d because some protein may be lost during dialysis. On Thanksgiving Day, high quality protein such as fish, lean meat and egg whites are recommended.

6. Monitor your potassium level

If the disease has damaged the kidney, potassium level in your blood will easily increase, so you should closely monitor your potassium level and be very careful with your potassium intake. You should avoid foods with high potassium content such as white beans, banana, salmon, white mushroom, nuts and avocados.

While it is not easy to live with kidney disease, prompt treatment and lifestyle changes can significantly improve your quality of life. As you join the rest of your family at the dining table to celebrate Turkey Day, make sure to use the above diet suggestions to avoid any detrimental effects the foods you consume may have on your health. If you have questions or something is unclear, be sure to speak with your urologist about it. At St Pete Urology, we have a team of highly-qualified and experienced urologists to help you overcome your kidney problem. For more information, visit the “St Pete Urology” site.

What does it feel like when you have a kidney stone?

Formed by crystallization of certain substances in urine, kidney stones are hard, pebble-like pieces of materials occurring in one or both kidneys when there are high levels of various minerals such as calcium or uric acid in urine. A kidney stone may be as small as a grain of sand, as big as a pebble or even as large as a golf ball. Generally, the larger the stone the more severe the symptoms. If the stone is very small in size, it can pass through your urinary tract without notice. But a large stone may cause a sharp pain in your side, groin, back or lower abdomen as it passes through the urinary tract.

So what does it feel like when you have a kidney stone?

Typically, kidney stones are formed in the kidney and a stone that remains in the kidney rarely causes pain. But when a kidney stone travels through the tubes of the urinary tract such as the ureter (tube connecting the kidney to the bladder) or the urethra (tube that leads outside the body), it may produce irritation and blockage that result in pain and other symptoms. You may feel the following symptoms depending on the size and location of the stones:

  1. No symptoms, if the stone is very small.
  2. Sudden and severe pain on the side, lower back, groin, abdomen or genitals. The pain gets worse in waves and is often described by people with kidney stones as “the worst pain I have ever experienced.”
  3. Nausea and vomiting, or a persistent stomach ache.
  4. Foul-smelling or cloudy urine
  5. Blood in urine, which occurs whether the stones remain in the kidney or travel through the ureters.
  6. Frequent and painful urination, often occurring when the kidney stone is in the ureter or after the stone has passed the bladder and is located in the urethra. In some cases, painful urination indicates a urinary tract infection occurring concurrently with the stones.

Remember there are other conditions, such as hernias, appendicitis, prostatitis and ectopic pregnancy, which may have the same symptoms. Therefore it is important to see a urologist so your condition is accurately diagnosed.

Abdominal and back pain

Kidney stones may occur in the urinary tract without causing any symptoms. In fact, if you have small stones, they are likely to pass through the urinary tract without causing pain or being noticed. However, this is often only possible before the stones move from your bladder into the ureter. Once inside the ureter or other tube of the urinary tract, kidney stones cause irritation and blockage which may lead to considerable pain and discomfort. The pain may begin while a stone is still in the kidney or after the stone moves into the ureter, urethra or bladder.

If the pain occurs while the stone is still in the kidney, it is felt in the side and on the back, typically on the same side of the body as that of the affected kidney. You also may feel a cramping sensation or a sharp pain in the pelvic area, lower abdomen or in the genitals.When pain is related to the movement of a stone through the urinary tract, it comes in waves and builds in intensity before fading in cycles of every 20-60 minutes.

Physical signs

As kidney stones move through the urinary system, you may feel a strong and frequent urge to urinate. Likewise, the movement of the stone can cause irritation and damage to the lining of the bladder or ureter, causing blood to mix with urine. As a result, you will find yourself passing bloody urine, which appears reddened, pink or rusty in color. The urine also can be cloudy or foul-smelling. Kidney stones may cause gastric distress, nausea and vomiting. If the movement of the stones through the urinary tract triggers an infection, you may experience fever and chills.

Seek prompt treatment

When you feel lasting symptoms or complications due to kidney stones, it is important to seek prompt treatment. At the doctor’s office, you will undergo thorough examination and diagnostic testing to confirm your condition. If you are diagnosed with kidney stones, your treatment will depend on the size and location of the stones. For example, if you have small kidney stones, the urologist may recommend increased fluid intake to enable the stones to pass on their own. But if the stones are large, the doctor may use a scope to remove them. In some cases, surgery may be necessary.

If you suspect that you have kidney stones, visit St Pete Urology for accurate diagnosis, effective treatment and comprehensive care. At St Pete Urology, we have successfully treated kidney stones and other urinary tract problems for several years. For more information, visit the “St Pete Urology” site.

Infographic: Everything You Need to Know About Kidney Stones

Everything You Need to Know About Kidney Stones

People sometimes may have kidney stones for several years without experiencing severe symptoms. The stones may pass out in urine with little pain and just a few mild-to-moderate symptoms. However, whether you have not had a kidney stone or only experienced a little pain when passing a stone, it is advisable to take precautionary steps to avoid more serious problems. For example, eating certain types of foods such as large amounts of lemons and oranges may cause kidney stones. But before eliminating various food items from your diet, you should consult a urologist. The urologist will conduct a proper evaluation of your current health status and provide clear guidance on which foods may cause kidney stones.

Common symptoms

A kidney stone often shows no symptoms until it has moved into the ureter. And when symptoms finally show, they commonly include:

  • Sudden, severe pain in the groin or in the side of your abdomen
  • A burning sensation during urination
  • Pain and difficulty during urination
  • A persistent urge to urinate
  • Reduced quantity of urine excreted
  • Nausea and vomiting
  • Blood in urine
  • Pus/white blood cells in urine
  • Chills and fever (if there is an infection)
  • Causes of Kidney Stones

Kidney stones typically vary in size, with some capable of growing as large as golf balls. The most common cause of the stones is lack of water in the body. The condition is often found in people who drink less than the recommended 8-10 glasses of water per day. When there is inadequate water in the body to dilute uric acid (a core component of urine), the urine will become more acidic and create a perfect environment for formation of the stones. Medical conditions like renal tubular acidosis, Dent’s disease, medullary sponge kidney, hyperparathyroidism, urinary tract infections and Crohn’s disease also increase the risk of kidney stones.

For prevention of kidney stones, you should:

  • Drink 2.5-3 liters of water every day
  • Reduce sodium or salt intake in your diet
  • Follow a healthy diet and avoid red meat. Daily or frequent consumption of red meat may cause kidney stones.
  • Exercise regularly and make sure to get enough sleep
  • Quit smoking and avoid alcohol
  • Treatment for kidney stones

The treatment is usually focused on managing the symptoms since passing a stone may be really painful. In the hospital, a urologist may choose:

  • Rehydration via an intravenous tube, accompanied with anti-inflammatory medication. Narcotics may be used to reduce the pain of passing the stones while antiemetic medication may be given to stop nausea and vomiting.
  • Extracorporeal shock wave lithotripsy (ESWL) may be performed by a urologist to break a kidney stone into small pieces to enable it to pass.
  • Laser surgery with ureteroscopy may be performed for large stones located in areas that do not allow for lithotripsy.
  • PNL/PCNL, flexible ureteroscopy, also may be considered by a urologist.

At St. Pete Urology, we offer many options and state-of-the-art facilities for successful treatment of kidney stones. For more information, visit the site, St Pete Urology.

Causes of Kidney Stones and Treatment Options

The United States has been experiencing a rise in the number of people with kidney stones over the last 30 years. While less than 4 percent of the population had the disease in the late 1970s, the portion of the population with the disease increased to over 5 percent by the early 1990s, and today 1 in 11 Americans has kidney stones. The stones occur more frequently in men than women, with Caucasians being more prone to developing the stones than African Americans.

The prevalence of the stones increases dramatically as men reach their 40s and continues to increase into their 70s. But for women, the occurrence of the stones peaks in their 50s. After a person gets more than one stone, the chance of other stones developing increases radically.

What causes kidney stones?

The major cause of kidney stones is a lack of fluids in the body, which allows minerals and salts to concentrate and crystallize over weeks or months to form the stones. Most often, the stones result from a build-up of certain chemicals in the body, such as ammonia, calcium, uric acid or cysteine. You are more likely to have kidney stones if you do not drink enough fluids.

It is also believed that high-oxalate foods such as spinach, peanuts, sweet potatoes, chocolate, okra, black Indian tea, wheat germ, beets and rhubarb, may increase the risk of developing kidney stones. In the South, often referred to as the stone belt, people tend to be dehydrated in the summer and drink a lot of tea, increasing the chances of developing stones.

You are also more likely to have kidney stones if you:

  • Are between 30-50 years old
  • Have a family history of kidney stones
  • Have hypercalciuria (unusually high amounts of calcium in urine).
  • Are taking certain medicines, such as diuretics (like triamterene) or protease inhibitors (like indinavir)
  • Are taking too much antacids, calcium, vitamin C or vitamin D supplements.
  • Have metabolic syndrome (a combination of many heart disease risk factors like high blood pressure, high sugar, unhealthy cholesterol levels and obesity)
  • Have a condition such as hyperthyroidism, gout or high blood pressure
  • Have cystitis
  • Have a condition that affects the structure or shape of your ureters or kidneys

Even though small kidney stones are often asymptomatic and may pass with little or no pain, large stones that block the urine’s path may cause severe symptoms. These could include sharp pain in the lower back or abdomen, painful urination, fever and chills, nausea and vomiting, blood in urine, and abnormally colored urine. It is important to visit your urologist if you experience such symptoms. The urologist will order blood and urine tests and imaging, and recommend appropriate treatment.

At St Pete Urology in St. Petersburg, we use minimally-invasive techniques and have a wide array of treatment options for kidney stones. If you think you may have kidney stones or have questions about the condition, visit the St Pete Urology website.

7 Common Symptoms of Kidney Stone and Treatment Options

The symptoms of kidney stones are largely determined by the size of the stones. For small kidney stones, the symptoms may be mild. In fact, small stones may go undetected and pass out of the body painlessly during urination. The most common symptom of kidney stones is pain which begins as a vague sensation then becomes sharp and severe as ureter muscles contract and relax around the stones. Initially, the pain is felt on the flanks or on the sides of the body, between the pelvis and ribs, including the lower back and upper abdomen. Later it moves to the groin or testicles as the kidney stone moves through the urinary tract.

Generally, the symptoms of kidney stones follow the migration of the stone across the urinary tract. The symptoms will depend on whether the stone gets stuck in the kidney, begins to travel down the ureter, or causes an infection.

Therefore, depending on the size of the stone, symptoms may include:

  • Sharp, persistent and severe ache in the side and back, often below the ribs
  • Pain which spreads to the groin and lower abdomen
  • Pain occurring in waves and with fluctuating intensity
  • Pain when passing urine
  • Restlessness and inability to lie still
  • Nausea and vomiting
  • Red, pink or brown urine
  • Foul smelling or cloudy urine
  • Urge to pass urine more often than usual
  • Urinating small quantities of urine
  • Chills and fevers if there is an infection

Blood in urine, often caused by the stone scratching the ureter or kidney
A kidney stone may cause an infection when it has blocked the ureter, preventing waste products from passing the blockage and resulting in bacterial build-up. It is the infection that causes symptoms such as fever, chills and shivering, diarrhea, foul smelling and cloudy urine, and fatigue.

Symptoms of Kidney Stone and Treatment OptionsIf you have these symptoms, it is important to see a physician, preferably a urologist. The doctor will perform a medical and symptomatic history, give a physical exam and order the necessary tests to confirm the presence of kidney stones and determine their size, location and appropriate treatment. The tests may include blood tests (like uric acid, calcium and phosphorous), tests for stone-forming salt crystals, infections, blood cells and stone factors, kidney function tests, and imaging tests (kidney ultrasounds, CT scans, MRI scans, abdominal X-rays and intravenous pyelograms). The urologist will recommend appropriate treatment after confirming the presence of stones.

If small, less-troublesome stones are detected, the urologist may recommend drinking 8-16 cups of water to flush them out. Along with the recommendation to drink plenty of fluid, the urologist may prescribe pain relievers such as ibuprofen, naproxen sodium or acetaminophen. In some cases, the urologist may offer a medication to help pass small stones from the kidney. The medication, called an alpha blocker, helps to relax ureter muscles and allows the stones to move quickly and painlessly out of the urinary tract.

Large stones are accompanied by various symptoms and should be treated using stronger measures. The urologist may use sound waves to break up the stones, a procedure called extracorporeal shock wave lithotripsy (ESWL). In some cases, the urologist will use a scope (a thin lighted tube equipped with a camera) to remove the stones. The urologist may also opt for percutaneous nephrolithotomy to surgically remove large stones, or even parathyroid gland surgery when necessary.

At St Pete Urology, we have experienced urologists and state-of-the-art facilities to ensure prompt diagnosis and effective treatment of kidney stones. If you have questions about this condition, visit St Pete Urology in St Petersburg for quality medical care.

10 Quick Facts About Lithotripsy by St Pete Urology

Lithotripsy is a medical procedure involving the disintegration of kidney stones, gallstones and bezoars using high-energy shock waves. Once the procedure is done, small stone fragments (or gravel) come out through urine. The Extracorporeal Shock Wave Lithotripsy (ESWL), in which the shock waves are produced outside the body, is the most common type of lithotripsy.

10 Quick Facts About Lithotripsy

1. An ESWL is generally done when a stone is too big to move on its own, or when it becomes entrapped in the ureter (the tube carrying urine from the kidney to bladder) causing enormous pain.

2. ESWL is not done on people weighing over 300 lbs, individuals with skeletal deformities, persons with severe bleeding disorders, and pregnant women. Patients with cardiac pacemakers should undergo this treatment only after being approved by a cardiologist.

3. Prior to lithotripsy, a thorough physical examination is done, followed by an intravenous pyelogram (IVP) test to determine the size, location and number of stones.

4. Older individuals should first undergo an EKG (electrocardiogram) test to detect possible cardiac defects. Also, women of childbearing age should take a pregnancy test. Some patients will have a stent inserted into the ureter to allow the passage of gravel through urine.

5. The entire lithotripsy process takes nearly an hour to complete, during which time up to 8,000 shock waves are administered. This may cause some discomfort to the patient based on tolerance level. In most cases, a urologist administers analgesics to relieve the pain.

6. After the treatment, most patients see blood in their urine. This clears out within a week, and patients are advised to drink extra fluids during this period to promote the flushing out of any stone pieces from the urinary system.

7. Patients should pay a follow-up visit to the urologist two weeks after the treatment to ensure that everything is going as planned. This is also the time when the stents will be removed.

8. The potential risks of the procedure include mild temporary abdominal pain. However, severe or persistent pain could imply an unexpected injury.

9. Renal pain is common when gravel passes through the urine. In about 60% of cases, blood clots may form in the kidney area. Other possible complications are pancreatitis, nerve palsies and obstruction of the stone pieces.

10. Alternatives to lithotripsy involve surgery (although this process has become obsolete) and altering the urine’s pH to dissolve the stones. These treatments, however, have had limited success.

Lithotripsy

Dr Reid Graves – Why Choose St Pete Urology

Dr Graves says that the St Pete Urology team of doctors and staff provide compassionate care to patients who often require difficult treatments in sensitive parts of their bodies. In most cases, patients are searching for answers to their medical questions, so the physicians strive to provide them with evidence-based solutions and treat them using the most advanced procedures. [Read Full Article…]

St Pete Urology Patient Care Options

St Pete Urology have successfully treated thousands of patients in the Tampa Bay Area with a focus on achieving the best possible results using the most advanced equipment and procedures. [Read Full Article…]