Kidney stones, solid deposits of mineral and acid salts that build up inside the kidneys, are relatively common—more than one million Americans are hospitalized every year with this condition, and approximately 10 percent of people in the United States will have a kidney stone sometime in their life.
Kidney stones occur more frequently:
- Between the third and fifth decade of life
- In men more than women
- In patients with a family history of kidney stones
- In patients in the southern United States
Symptoms may include:
- Sudden, severe, excruciating pain in the flank (one side of the body between upper belly area and back) or mid-back area, due to the stone moving in the urinary tract
- Nausea and vomiting
- Pain on the side or back that can radiate down towards pelvis or groin
- Abnormal urine color or appearance
- Loss of appetite
If fever or chills are present with any of these symptoms, an infection may be present, and you should see a doctor immediately.
At MedStar Southern Maryland Hospital Center, our urology specialists offer both surgical and non-surgical management of urinary calculus disease, the condition that leads to the formation of kidney stones. Surgery for your kidney stones might be necessary if the stone:
- Causes too much pain
- Becomes too large to pass spontaneously
- Blocks urine flow
- Causes tissue damage
- Results in some type of urinary tract infection
Open surgery, where the kidney is opened for stone removal, is usually unnecessary. Instead, one of several non-invasive techniques is recommended depending on the size, location and number of the stones present. These include:
- Lithotripsy or Extracorporeal Shockwave Lithotripsy (ESWL) is the most frequently used and does not require an incision. Shock waves break up the stones into smaller sand-like fragments which can then pass on their own.
- Percutaneous Nephrolithotomy (PCNL) is recommended if the stone is too large or located in a place in the urinary tract that may not allow for effective ESWL results. A small incision or puncture is made in the back through which kidney stones can be removed. This procedure is suitable for stones while present in the pelvic region.
- Ureteroscopy is a procedure that uses a small telescope (ureteroscope), which is inserted through the urethra without an incision and into the bladder, ureter and kidney. The stone is then removed via a cage-like instrument or shattered with a holmium laser. Unlike ESWL and PCNL, ureteroscopy can be performed in patients on blood thinners. Large stones (>2cm) may be treated as well; however, it may require more than one trip to the operating room.