Kidney and ureteric stones ( Calculous disease of kidney and ureters)

Background 

Kidney stones also called as Nephrolithiasis is very common problem across the world with prevalence around 12-15% in the general population with higher recurrence rates of renal stones up to 30%. Through it is commonly seen in males but it’s is also encountered in females frequently. There are multiple dietary and environmental concerns which influence the incidence of kidney stones. Ureteric stones are commonly associated with slippage of stones from the kidneys. 

Kidney act as organ of filtration from the waste substances of the body but it’s tubules tend to accumulate certain ions like calcium, magnesium, Oxalates which deposit in kidney to form stones.

Causes and risk factors of kidney stone: 

  1. high intake of diet containing  calcium and oxalates
  2. Infection of urinary tract system 
  3. Diabetics and obesity 
  4. Metabolic syndromes and inherited metabolic disorders like cystnuria
  5. Gout 

Symptoms of kidney and ureteric stones :

  1. Sharp pain in lumbar region ( flanks) extending towards groin and thigh 
  2. Pain associated Severe nausea and vomiting 
  3. Indigestion and fullness of abdomen
  4. Burning of urine or blood present in urine 
  5. Frequent urinary infections
  6. Fever with chills in case of ureteric obstruction causing sepsis 
  7. Long standing stones causing kidney failures

Diagnosis and investigations 

These are common symptoms and patients usually present in emergency with acute abdominal pain. Initially the pain is relived with medications and patients are further investigated with routine blood and urine examination and ultrasonography of the abdomen. Contrast enhanced computerised tomography ( CECT) abdomen is done to assess the size, location of the stones and functions of the kidney. CT abdomen in acute settings will also be useful to rule other cause of acute abdomen in emergency.

Treatment of kidney and ureteric stones 

Once the diagnosis is confirmed the treatment further depends upon the size and site of the stone. Usually small stones ~ 5-6mm  can be filtered out from kidney and ureter with medications and high intake of water and fluids.

Larger stones will need surgical intervention from urologists. Urologist surgeons have various endoscopic surgical procedures in there arena which deal with stones depending upon there size and location.

The common surgical procedures used  for kidney stones are PCNL( Percutaneous nephrolithotomy), mini- PCNL for paediatric age group, laparoscopic stone removal from kidney pelvis and conventional open procedures in cases of large stones or damaged kidneys. 

Ureteric and kidney pelvis stones are dealt with Uretroscopic removal of stones (URS) , RIRS( Retrograde intra renal Surgery) sone using flexible endoscope along with adjunct use of lasers to break the stones( laser lithotripsy). 

Recovery after surgery 

These endoscopic and laser techniques and have made the urology surgeries absolutely scarless and painless experience for patients. Patients can be discharged from the hospital on same day or 1-2 days depending upon type of surgery. They can resume normal diet and activities once they start feeling comfortable. 

To consult with best team of urologist surgeons available at The Surgeons House (SHL) in different global locations, please click this link for more details. 

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