Kidney stones

Sometimes urine contains so much waste material that it crystallises to form small stones in the kidney. Most people's urine contains chemicals that stop the crystals from forming. However, in some cases, these chemicals do not work efficiently.

The most common cause of kidney stones is not drinking enough fluids. They also develop through urinary tract infections and prolonged bed rest.

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Kidney stones symptoms

Most stones start off the size of a small piece of gravel and can even pass out of the body unnoticed. If the stones are large they can become very painful. However, it can take years before they grow to a size that is big enough to cause symptoms.

Larger stones, or fragments of stones, can travel down the ureter (the tube from the kidneys to the bladder). This can cause extremely painful spasms of the wall of the ureter, referred to as renal colic. Symptoms can appear suddenly, including:

  • Excruciating pain starting in the back and spreading to the abdomen, groin and even down to the genitals.
  • Frequent, painful urination.
  • Nausea, vomiting.
  • Blood in your urine.

Kidney stones diagnosis

A doctor will test your urine for blood or signs of infection. He or she may also check for signs of crystals and test urine acidity, as this may indicate what type of stone you have.

You may also have an X-ray of your kidneys, as 90% of stones are visible on X-ray. If you have no symptoms, it is common for these 'silent' stones to be picked up only when you have an X-ray for another reason, for example a general health examination.

The doctor may also scan your urinary system using a special X-ray test called intravenous pyelography (IVP). A harmless dye is injected into a vein. It becomes concentrated in the kidneys and is passed into the urinary tract system. The dye shows up on X-ray and provides detailed images of the kidneys, ureters and bladder.

Kidney stones treatment

If the stones are only small and they stay in the kidney, you may be advised to simply drink lots of fluids to help flush the stones out; you should also rest and take painkillers to relieve the discomfort.

Other forms of treatment include:

Extracorporeal shockwave lithotripsy

  • The most common form of treatment for kidney stones.
  • Ultrasound waves transmitted through the skin and tissue cause the stones to break down into a powder, which can be easily passed through the urine with little pain.

Ureteroscopic stone removal

  • A small tube is passed through the urethra into the bladder and ureter. A surgeon can pass instruments through this tube to remove or crush the stone.

Percutaneous nephrolithotomy

  • Suitable for very large or awkwardly positioned stones.
  • A surgeon makes a tiny cut in your back and creates a tunnel directly into the kidney.
  • Using an instrument called a nephroscope, the surgeon finds and removes the stone.

Open Surgery

  • Rarely used today, but sometimes necessary, usually in the case of very large stones known as staghorn stones.

Preventing kidney stones from coming back:

  • Drink at least 3 litres of fluids a day to avoid dehydration.
  • Drink fluids before you sleep to make sure that you continue to produce urine overnight.
  • Drink more fluids in hot weather and if you have been taking strenuous exercise.

Need more information?

Speak to your GP if you show any sign of having kidney stones, or just want some advice about treatment. You can also find other useful websites via our links section.

Kidney

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Bladder

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Prostate

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Male reproductive organs

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