4 methods for kidney stone removal
Retrograde intrarenal surgery (RIRS) is the best procedure for removing kidney stones and consists of the following steps.

The treatment of kidney stones will depend on various factors, such as:

  • Size
  • Location
  • Type
  • Infected and noninfected
  • Whether it is a first-time procedure or a repeat procedure

However, now, retrograde intrarenal surgery or RIRS, also called flexible ureteroscopy, is the best procedure for removing kidney stones.

  • This procedure refers to surgery done inside the kidney with a viewing tube, which is called a fiber optic endoscope.
  • Due to recent technological strides in this field, it has become possible to implement RIRS to manage kidney stones.
  • The laser energy source is used to break the stone or convert it into dust, which the stone particles can be manually removed using a pair of small forceps.
  • This procedure is a natural hole surgery and is associated with minimal complications.
  • This surgery is performed inside the kidney without making any cuts by directing the instrument through the urethra and into the kidney.
  • After completing RIRS, the patient will be taken to the recovery room where they will receive intensive care.

However, the procedure is costly due to the higher cost of equipment and disposables, and it has a lengthy learning curve.

Other treatment options for kidney stones

  • Smaller kidney stones, ranging in size from a dust particle to a grain, may not even require treatment and may pass through the urinary tract on their own or with the help of certain medications and precautions prescribed by the urologist.
  • A healthy kidney necessitates adequate water intake regularly.

For recurrent or large kidney stones

  • Extracorporeal shock wave lithotripsy (ESWL): It employs shock waves to shatter kidney stones into small pieces that can pass through the urinary tract and out of the body.
  • Ureteroscopy (URS): In this procedure, a ureteroscope is passed through the urethra and into the ureter to remove a stone with a laser.
  • Percutaneous nephrolithotomy (PCNL): Large kidney stones are removed through a small incision in the skin in this minimally invasive procedure.

5 ways to prevent kidney stones

  1. Changes in lifestyle, particularly eating and exercise habits can help people avoid or prevent kidney stones.
  2. A person with a history of kidney stones should drink about two to three quarts of water per day (unless on a fluid-restricted diet).
  3. Protein-restricted diets can help reduce the risk of developing certain types of kidney stones.
  4. Besides dietary changes, the doctor may prescribe medications to help control the amounts of certain minerals that develop in the urine.
  5. Some people develop calcium kidney stones as a result of the parathyroid glands producing too many hormones. Surgically removing one or more of these glands can prevent the formation of kidney stones.

If a person has kidney stones, they may be more likely to develop chronic kidney disease

Talk to the doctor about how to keep the kidneys healthy and prevent kidney stones from recurring.

How are kidney stones formed?

Most urinary stones form as a result of a shift in the natural balance of minerals and water in the urine.

  • They are made up of salt and minerals found in urine that sticks together and form small clots.
  • The stones are rarely larger than a grain of rice, but they can grow to several centimeters in diameter and even fill the entire renal collecting system in some cases.
  • They can either remain in the kidneys or exit the body via the urinary tract.

Doctors distinguish between the types of salt that the stone comprises, for example:

  • Calcium oxalate stones (70 to 75 percent)
  • Uric acid stones (up to 10 percent)
  • Infectious stones, such as struvite stones, consisting of magnesium ammonium phosphate (approximately 10 to 15 percent)

6 common causes of kidney stones

The following are factors that can alter the balance of substances in the urine, which leads to kidney and urinary stones.

  1. Inadequate water intake, which can lead to salts and minerals clumping together to form small stones
  2. A diet high in protein or sodium
  3. Urinary tract infections
  4. Obesity, diabetes, gout, and metabolic syndrome
  5. A parathyroid gland regulatory disorder (hyperparathyroidism)
  6. Bowel surgery, gastric bypass, and Crohn's disease

Kidney stones are a common occurrence with one in every 20 people developing them at some point in their lives, according to estimates.

  • Men are at an 11 percent risk of developing kidney stones, and women are at a 9 percent risk.
  • People who take certain medications or supplements are more likely to develop kidney stones.
  • Stone formation is also influenced by hereditary factors.

Other causes of kidney stones include strenuous exercise with insufficient fluid replacement and eating foods high in salt or sugar.

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How do I know if I have kidney stones?

A person may not realize they have a kidney stone until it causes pain, becomes large, and obstructs the flow of urine. The most common symptom is severe, fluctuating pain under the ribs in the lower back or side.

Other signs and symptoms include:

If a person has a kidney stone, their doctor may recommend one or more of the following diagnostic tests and procedures:

  • Blood test: Blood tests may reveal an excess of calcium or uric acid in the blood. Blood test results help the doctor monitor the health of the kidneys and may prompt them to check for other medical conditions.
  • Urine tests: The urine will usually be tested for blood (most patients with a stone have a trace of blood in their urine) and pH with a special dipstick (acidity). If white blood cells or nitrites are detected on the test, especially if the history suggests infection, the doctor may request that a urine sample be sent to a laboratory to determine whether bacteria are present.
  • Imaging:
    • Urinary tract imaging tests may reveal kidney stones. Even small stones can be detected using high-speed or dual-energy computed tomography. Because simple abdominal X-rays can miss small kidney stones, they are used less frequently.
    • Another imaging option to diagnose kidney stones is ultrasound, a noninvasive test that is quick and easy to perform.
  • Analysis of passed stones: A person might be asked to urinate through a strainer to catch any stones that pass through. The composition of the kidney stones will be revealed through laboratory analysis. This information is used by the doctor to determine what is causing the kidney stones and devise a plan to prevent future stones.

Once a person has been diagnosed with a kidney stone, the doctor will determine the best course of action. Overall health, as well as the size and location of the stone, will be considered.

Prevention is the best way to deal with kidney stones. Staying hydrated by drinking plenty of water each day helps clean the kidneys. In some cases, a change in diet and doctor-prescribed medications may be enough to reduce the patient's risk of kidney stones. 

If additional treatment is required, the doctor or urologist will be able to advise on options. The best type of treatment and the cost of removing kidney stones will be determined by the doctor's recommendation based on the diagnosis of the kidney stones.

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Medically Reviewed on 1/5/2022
References
Image Source: iStock Images

National Institutes of Health. Treatment for Kidney Stones. https://www.niddk.nih.gov/health-information/urologic-diseases/kidney-stones/treatment

Washington University. Surgery for Kidney Stones. https://urology.wustl.edu/patient-care/kidney-stones/surgery-for-kidney-stones/

Urology Care Foundation. Recent Innovations in Kidney Stone Treatment. https://www.urologyhealth.org/healthy-living/care-blog/2018/recent-innovations-in-kidney-stone-treatment

University of Utah Health. What to expect at your kidney stone surgery. https://healthcare.utah.edu/urology/conditions/kidney-stones/surgery-what-to-expect.php