Kidney stone treatments: your options

As someone who has had kidney stones and a history of other kidney problems, I have a definite interested in the topic. And, I have to admit to being curious about what kidney stone treatments are available for anyone having to deal with them.

I was able to speak with Benjamin Lee, MD, who is the Chief of Urology with the University of Arizona School of Medicine and a urologist in Tucson. Dr. Lee noted several treatments and a few facts about kidney stones I had always wondered about.

To put the issue into perspective, let’s look at some numbers:

  • In 2000, 2 million people saw a doctor for kidney stones, totaling $2.1 billion in medical costs.
  • 13 percent of men and 7 percent of women will have kidney stone.
  • 1 in 11 people in the United States will develop a kidney stone.
  • Once someone has developed a stone, there is a 50 percent chance they will get another one in 5 years.
  • Kidney stones range in size from 2 to 3 millimeters (very small) up to the size of a tangerine.

Not every stone needs to be treated, though. Some are small enough to pass on their own when you urinate. Dr. Lee noted a 3 mm stone has about 80 percent chance of passing on its own. At about 5 mm, the odds are about 50 percent, but if a stone reaches 8 mm, the odds drop to 20 percent.

So, when are stones treated? Typically, if the stone blocks the kidney, which then doesn’t allow urine to drain, that’s when pain occurs. Most kidney stones will need treatment if there is swelling of the kidney, a term called hydronephrosis, according to Dr. Lee. “Additionally, someone with a solitary kidney, only one kidney, will get the stone taken out before long term damage and loss of kidney function occurs,” Dr. Lee said.

Kidney stone treatments

Dr. Lee said there are three primary surgical treatments for kidney stones:

  • Extracorporeal Shock Wave Lithotripsy. For smaller stones, the urologist may choose lithotripsy. This procedure uses X-rays to locate the stone and the sound waves from an ultrasound breaks the stone down into smaller pieces. Once broken into smaller pieces, you can pass the stone normally. This minimally invasive procedure can be done on an out-patient basis.
  • Ureteroscopy. This procedure involves inserting a small flexible telescope into the urethra, the tube that allows urine to flow out of the body. From there, the scope can move through the bladder to the ureter, the small tube that connects the kidney to the bladder. Then, the physician can use laser to break the stone down into smaller pieces, or simply basket the stone to remove. The amazing aspect is that there are no incisions to make — a completely scarless surgery. Again, this is typically an out-patient procedure.
  • Percutaneous Nephrolithotomy. It’s a mouthful, isn’t it? You’ll want to know doctors usually use this procedure for larger stones, and it involves a small 1 centimeter incision. The physician will make a small incision in the lower back and into the kidney. Then, the doctor inserts a telescope to see the stone. A special lithotripter probe is used to break the stone into smaller pieces to be removed through the small incision. Dr. Lee noted that this procedure can clear the stone very well, but it does require surgical skill.

After the stone passes or the doctor removes it, the doctor will likely have it analyzed to find out what type of stone it is. This analysis can help determine if there are medications that can help prevent stones in the future.

Dr. Lee said more people suffer from kidney stones when the temperatures climb. You can probably guess why: People are not properly hydrating. With proper fluid intake, it is harder for kidney stones to form.

But, there’s one last piece of advice that Dr. Lee has:

“Lemonade can be very helpful in preventing stones from forming,” he said, due to the citric acid which binds with calcium and helps prevent calcium stones from forming.

So, an ice-cold glass of lemonade on a warm summer day may be just what the doctor ordered. Want to skip the sugar? Try a glass of water with a slice of lemon.

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