Question 1

What treatment options are available for removing kidney stones?

Accepted Answer

Treatment options depend on the stone's size, location and composition, ranging from watchful waiting with increased fluid intake for small stones likely to pass naturally, to extracorporeal shock wave lithotripsy (ESWL), which uses sound waves to break stones into smaller pieces, ureteroscopy, where a thin scope removes or breaks up stones directly, and percutaneous nephrolithotomy for larger, more complex stones, involving a small incision in the back. Your urologist will recommend the most appropriate option based on your specific stone characteristics.

Question 2

What is lithotripsy and how does it break up kidney stones?

Accepted Answer

Lithotripsy, specifically extracorporeal shock wave lithotripsy (ESWL), uses focused sound wave energy directed from outside the body to break kidney stones into smaller fragments that can then pass more easily through the urinary tract naturally. It's a non-invasive procedure typically done under sedation, taking about 45-60 minutes, and is most effective for stones of moderate size in accessible locations. Some patients may need more than one session, and smaller stone fragments may take a few weeks to fully pass afterward.

Question 3

What is ureteroscopy and when is it used for kidney stones?

Accepted Answer

Ureteroscopy involves passing a thin, flexible scope through the urethra and bladder up into the ureter or kidney to directly visualise and remove or break up a stone, often using a small laser to fragment larger stones for easier removal. It's commonly used for stones located in the ureter or lower part of the kidney, and doesn't require any external incisions, though a temporary stent is sometimes placed afterward to help the ureter heal and allow urine to drain properly.

Question 4

How can kidney stone recurrence be prevented?

Accepted Answer

Prevention strategies depend on the specific type of stone you had, identified through stone analysis, but generally include drinking plenty of water to keep urine dilute, reducing salt intake, moderating animal protein consumption, and, for certain stone types, adjusting intake of specific foods like those high in oxalate. Some patients benefit from specific medications to prevent particular stone types from reforming. A metabolic evaluation after a kidney stone, especially if you've had more than one, can help identify your specific risk factors and guide targeted prevention.

Question 5

What kidney stone symptoms need emergency evaluation?

Accepted Answer

Seek emergency evaluation for severe, sudden flank or abdominal pain, especially if accompanied by fever and chills, which can indicate an infected, obstructed kidney requiring urgent treatment, as well as persistent vomiting preventing you from staying hydrated, or visible blood in the urine with severe pain. A stone blocking urine flow combined with infection is a urological emergency that needs prompt treatment, so don't wait to see if severe symptoms improve.

Kidney Stone Removal