Hardened mineral deposits formed in the kidney are called kidney stones (calculi). These originate as microscopic particles and over the course of time develop into stones. Medically this condition is known as nephrolithiasis or renal stone disease. The kidneys filter waste products from the blood and add them to the urine.
When waste materials in the urine do not dissolve completely and the kidney is unable to evacuate them, crystals and kidney stones are likely to form. Some stones may pass out of the kidney or get lodged in the ureter (tube that carries urine from the kidney to the bladder) and cause severe pain that starts from the low back and radiates to the side or groin.
A lodged stone can block the flow of urine and build a backpressure in the affected ureter and kidney. Increased pressure results in stretching and spasm causing severe pain in the lower back.
Diagnosis of Kidney Stones
In addition to a complete medical history and physical examination, diagnostic procedures for kidney stones may include the following:
Intravenous Pyelogram (IVP): A series of x-rays of the kidney, ureters, and bladder with the injection of a contrast dye into the vein - to detect tumors, abnormalities, kidney stones, or any obstructions, and to assess renal blood flow.
Urinalysis: Laboratory examination of urine for various cells and chemicals, such as red blood cells, white blood cells, infection, or excessive protein.
Blood Tests: Laboratory examination of the blood to detect substances that might promote stone formation.
Renal Ultrasound: A non-invasive test in which a transducer is passed over the kidney producing sound waves which bounce off the kidney, transmitting a picture of the organ on a video screen. The test is used to determine the size and shape of the kidney, and to detect a mass, kidney stone, cyst, or other obstruction in the kidney.
Treatment of Kidney Stones Surgery
Extracorporeal Shock Wave Lithotrispy (ESWL): Extracorporeal shockwave lithotripsy (ESWL) is a procedure used to break down kidney stones.Kidney stones are small, solid masses that form when salts or minerals normally found in urine become solid crystals inside the kidney. Usually, the crystals are very small and pass harmlessly out of your body. But if they build up inside your kidney, they can cause pain, infection and damage your kidney function.
Sometimes, smaller kidney stones move out of the kidneys into the tubes that carry urine from your kidneys to the bladder (ureters). These small stones can cause severe pain if they rub against or get stuck in your ureters.
Percutaneous Nephrostolithotomy (PCNL): Percutaneous Nephrolithotomy, or PCNL, is a procedure for removing medium-sized or larger kidney stones from the patient's urinary tract by means of a nephroscope passed into the kidney through a track created in the patient's back. This procedure uses an ultrasonic or laser probe to break up large kidney stones and suction it out. This procedure is usually done under general anesthesia or spinal anesthesia. In percutaneous nephrolithotomy or nephrolithotripsy, the surgeon makes a small incision in your back to remove kidney stones. He or she then puts a hollow tube into your kidney and a probe through the tube.
In nephrolithotomy, the surgeon removes the stone through the tube. In nephrolithotripsy, he or she breaks the stone up and then removes the fragments of the stone through the tube. The purpose of PCNL is the removal of renal calculi in order to relieve pain, bleeding into or obstruction of the urinary tract, and/or urinary tract infections resulting from blockages.
Percutaneous Nephrostolithotomy (PCNL)Ureteroscopic Lithotrispy with Holmium Laser: This procedure is performed under Epidural and Spinal Anesthesia to treat stones located in the middle and lower ureter. A small, fiberoptic instrument (ureteroscope) is passed into the ureter. Large stones are fragmented using 100-Watts Coherent Holmium Laser. The laser fragments stone into sand like particles, which are then flushed out through the natural urinary passage. The advantage of Holmium Laser is its ability to fragment stones of all compositions and precision. Thus, it is the most effective laser for the treatment of ureteric stones. Patients are generally admitted on the same day of the treatment and are discharged next day, which means only 24 hours hospitalization.
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