Kidney Stone Treatment

Kidney Stone Treatment

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    Staghorn stones are large, branched stones occupying a large volume of the kidneys. The most effective treatment option is percutaneous nephrolithotomy, where the urologist inserts a scope directly into the kidney via a 1/2 inch tract made in your flank. Open surgery for kidney stones is strongly discouraged and reserved for only very rare cases with a very large stone burden or very unusual anatomy.

    In some cases, the stone is made of uric acid, and in these cases, medications alone may help dissolve the stone and one can avoid surgery.

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    Ureteroscopy is a procedure in which a small scope (like a thin flexible telescope) is inserted into the bladder and ureter (tube that goes from a kidney to the bladder) to diagnose and treat a variety of problems in the urinary tract. For ureteral stones, it allows the urologist to actually look into the ureter, find the stone and remove it. The surgeon passes a tiny wire basket into the lower ureter via the bladder, grabs the stone and pulls the stone free. This is an outpatient procedure that does not require an overnight hospital stay.

    Depending on the skill and experience of the urologist, ureteroscopy can be used for virtually any size stone.
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    A , Urology, answered
    Sodium Bicarbonate (chewable tablets or powder) is probably the only readily available over-the-counter (OTC) medication to treat uric acid kidney stones. It is useful in patients who have persistent acidic urine as the cause of their uric acid stones. Patients must test their urine regularly with pH paper (which turns different colors depending on whether the urine is acidic or alkaline). Too much sodium bicarbonate will make the urine too alkaline and promote the formation of calcium phosphate stones.
    Note: Consult your health care provider before starting any OTC or other medication. Patients taking sodium bicarbonate may experience an increase in side effects or a decrease in effectiveness of their current medications. 
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    A , OBGYN (Obstetrics & Gynecology), answered
    Intake of Vitamin D should not exceed the recommended age-specific daily limits in patients with kidney stones.
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    The recurrence of your kidney stones can be prevented with several daily choices. You should drink plenty of water (some doctors recommend 12 glasses of water each day) and watch what foods you eat. Some might be causing the build-up of minerals in your kidneys that lead to recurrent kidney stones. If your doctor has prescribed drugs to prevent future stones, be sure to take all medications as directed even when you feel better.

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    It is normal to see blood in the urine for several weeks after extracorporeal shock wave lithotripsy (ESWL). However, large amounts of blood or blood clots in the urine may indicate that the kidney was injured by ESWL treatment.

    Although ESWL is a relatively safe treatment, it is important to note that adverse events, although uncommon, do occur. You should contact your doctor if you experience increasing pain, or pain that is getting worse instead of getting better. This may indicate either that there is bleeding around the kidney as a result of ESWL or that the kidney stone fragments have all fallen into the ureter and are blocking the drainage of urine from the kidney.

    In addition, the presence of a fever may indicate that there is a serious kidney infection.

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    If the stone is small – less than 5 mm – and not causing any pain, there is a good chance that it will pass on its own after it falls into the ureter. Such stones may be followed with watchful waiting, a treatment strategy whereby kidney stones are not actively treated, but instead are monitored over time, with periodic X-rays, to ensure that they are not changing or causing problems. However, stones larger than 5 mm in size are unlikely to pass on their own, and should be considered for treatment.

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    The main risk of extracorporeal shock wave lithotripsy (ESWL) for kidney stones is that it doesn't always work. After ESWL, about 50% of people will be free of kidney stones within a month. In others, stone fragments of various sizes remain, and a repeat procedure (or a different procedure) is needed.

    ESWL has the potential to cause kidney injury. Whether or not ESWL causes or leads to the development of high blood pressure and diabetes remains controversial. These possibilities are still being studied. You should ask your doctor about risks and benefits of ESWL in your situation.
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    A answered
    Doctors may prescribe anti-inflammatories (NSAID) to help with the pain. The over-the-counter anti-inflammatory that I use is ibuprofen, usually 600 milligrams. For severe colic we use a stronger, injectable NSAID called ketorolac. It’s a very potent anti-inflammatory and will stop the spasms that you’re having with a kidney stone almost within a few minutes.
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    Kidney stones respond best to medical treatments. You can use alternative treatments to reduce your risk for future kidney stones, however. Some people have found that drinking lemon juice or orange juice helps them have fewer kidney stones. Tea is more controversial; green tea may be preventive, while the oxalate in black tea may encourage the formation of kidney stones. Others find that drinking several glasses of water each day keeps their system healthy. Depending on the kind of kidney stone you have, your doctor might recommend a change in your diet.