Oklahoma Lithotripter Associates
Oklahoma Kidney Stone Center
5401 N. Portland, Suite 650
Oklahoma City, OK 73112

Kidney Stones Treatment

1. What are Kidney Stones?
2. What do Kidney Stones look like?
3. Where are the Stones present?
4. What are the symtoms of Kidney Stones?
5. What damage does Kidney Stones cause?
6. What are the treatment options for Kidney Stones?
7. What is Extracorporeal Shock Wave Lithotripsy (ESWL)?
8. What are the advantages of Litotripsy over surgery?
9. How long does the treatment take?
10. If required when will the tube be placed inside the kidney?
11.What will happen to the stent in the kidney?
12.Do stones always pass out after lithotripsy treatment?
13.What is Endoscopic Lithotripsy?
14.How are stones in the Ureter removed?

(Q)--What are Kidney Stones?

Kidney stones are a common and painful medical problem. Kidney stones build up from a chemical imbalance in the urine. They may be smooth and rounded or make an uneven "mold" of the inside of the kidney, completely filling up the small ducts. The irregular stones are sometimes called staghorns because of their shape, or infective stones because they happen during urinary tract infections. Stones also become problems when they leave the kidney and pass through the ureter, causing crampy pain, nausea, vomiting, and sometimes blood in the urine. Stones may also become stuck in the ureter, causing severe pain or infection.

Kidney stones are mostly seen in people of middle age. They are three times more common in men than in women. They tend to come back repeatedly.

Many Factors contribute to the development of kidney stones; heredity, dietary factors, and reasons unknown to modern medicine...

The renal calculi can cause severe pain as they pass from the kidney and travel down the ureter towards the bladder and urethra. Often these calculi become lodged within the kidney or ureter causing retention of urine within the kidney, severe pain, and/or infection. The Urologist will commonly place a stent (small tubing) up the ureter to allow urine to pass and provide relief for the patient until the stone passes or is removed. If the calculus does not pass by itself, the Urologist will use a surgical procedure called Cystoureteroscopy to obtain access to the kidney stone. The calculus can then be removed using a variety of methods. These methods may include grasping the calculus with a basket like device or even crushing the calculus using laser or sound waves. Patients undergoing Cystoureteroscopy usually go home within several hours following surgery. Minor discomfort is expected and often the stent will remain to allow fragments to continue to pass. The stent will be removed at a later date.

Q)--What do Kidney Stones look like?

Kidney stones may be small or large and either smooth or jagged. They are usually yellow or brown.

(Q)--Where are the Stones present?

The stones may be in the Kidney, ureter or the urinary bladder.

(Q)--What are the symptoms of Kidney Stones?

  • Pain
  • Blood in your urine
  • Fever and chills
  • Vomiting
  • Urine that smells bad or looks cloudy
  • A burning feeling when you urinate

    (Q)--What damage does Kidney Stones cause?

    Small stones can cause pain as they pass from the kidneys down to the bladder while large stones can get stuck in the kidney or in the bladder and cause pain, infection and kidney damage. Obstruction and infection can result in kidney failure.

    (Q)--What are the treatment options for Kidney Stones?

    The complete approach to stone disease involves treatment of the existing stone and preventive measures against recurrence. The majority of kidney stones pass by themselves through the urinary tract and out with the flow of urine. However pain can be so severe that hospital admission and pain killer medicines are required. Sometimes an open operation is needed to remove stones. Many stones can be removed with endoscopic keyhole surgery i.e. extraction with the aid of telescopes... Now a new invention, the lithotripter, is available for effective treatment of kidney stones with little pain or discomfort using an intense beam of ultrasound to smash large kidney stones into small fragments

    (Q)--What is Extracorporeal Shock Wave Lithotripsy (ESWL)?

    During ESWL the stone is localized using an image intensifier and high frequency shock waves (water pressure) are focused onto the stone which results in its mechanical disintegration into small particles.

    The doctor can see on the x-rays that the stone has been crushed by the shock waves. Subsequently the stone fragments pass out in the urine. This process may require to be repeated for large stones. For large stones and patients with ureteric obstruction a Double J Stent (a temporary ureteric tube) may be needed to be placed by a cystoscope through the normal urinary passage. One end of the stent lies in the kidney while the other in the bladder with nothing visible from outside. This dilates the ureter and prevents obstruction during the passage of stone particles. When the patient is stone free, the stent is removed with the help of cystoscope without any operation.

    (Q)--What are the advantages of Litotripsy over surgery?

  • No incision and no scars (as after surgery)
  • Safe - no anesthesia
  • Age no bar - Safe even in children and elderly
  • No blood transfusion or AIDs risk
  • OPD walk-in walk-out treatment – Minimum work loss
  • Treatment can be safely repeated in recurrent stones
  • Comfortable - Most patients need nil or minimal sedation and pain killers (analgesics)
  • Life saving for patients unfit for surgery, single kidney patients etc.
  • Economical

    (Q)--How long does the treatment take?

    Plan on a six to seven hour stay from the time you arrive at pre-admission. The Actual treatment will take around a hour to an hour and a half. The extra time is for you to be admitted, evaluated by the anesthesiologist and other physicians, and to recover.

    Single small stones may take less time to clear and large or multiple stones will take longer and multiple treatment sessions

    (Q)--If required when will the tube be placed inside the kidney?

    For large stones a Double J Stent is usually placed before ESWL. This is often done under general anesthesia but can be done under local anesthesia, on patient’s choice.

    (Q)--What will happen to the stent in the kidney?

    The Stent has to be removed when the stone is cleared.

    (Q)--Do stones always pass out after lithotripsy treatment?

    Sometimes stone clearance is delayed by a fragment, which blocks the ureter. The doctor may advise the patient to have this removed by ureteroscopy.

    (Q)--What is Endoscopic Lithotripsy?

    Many stones can be removed without conventional surgery by introducing small telescopes into the body either through normal urinary passage or through a pencil size hole in the skin (the percutaneous approach).

    (Q)--How are stones in the Ureter removed?

    Suitable stones within the ureter can be crushed with ESWL, be removed, pushed back to the kidney for subsequent ESWL or broken down by small portable lithotriptor under direct vision and removed using forceps. This avoids the need for open surgery.