Kidney and Ureteral Stones
Kidney stones are quite common, with a 5-10% chance of forming stones during the span of a lifetime. Although they could occur at any age, they most often occur between the ages of 30 – 50 years.
Kidney stones form when there is an imbalance of minerals or acid salts in the urine. This may be linked to the amount of fluids that you drink, and whether there are substances in your urine which promote stone formation, or a lack of substances which inhibit stone formation.
Patients’ symptoms vary from no pain to excruciating pain. This depends on the size of the stone, the location of the stone, and whether it is causing an obstruction to the normal flow of urine. When a stone is stuck in the ureter, there is a sharp pain (usually of sudden onset) in the loin region, and often radiates to the groin. This pain (also called renal colic) is unrelenting, and does not decrease with any change in position. Other associated symptoms might also be present such as nausea & vomiting, blood in the urine (haematuria), painful urination, and fever.
Diagnosis and Treatment
In order to make a diagnosis of kidney stones, the urologist usually takes a medical history, performs a physical examination, and orders urine and blood tests. A CT scan is then performed to ascertain the shape, size and location of the stone. Based on the findings of physical examination, the CT scan and blood tests, a decision is made to either await spontaneous passage of the stone or to engage in active treatment for removal of the stone. The most typical ways to remove stones are by shock-wave lithotripsy (SWL), ureteroscopy (URS), and percutaneous nephrolithotomy (PCNL).
With active treatment, a drainage tube called a J-J stent is usually inserted to drain the kidney into the bladder. This is an internally placed tube and is not visible to the naked eye. It is usually removed in the consulting rooms 7 – 10 days after the surgery.