What are the early symptoms of kidney stones?
Unfortunately, kidney stones do not cause any symptoms until they move around in your kidney or pass through your ureter, the tube connecting the kidneys and urinary bladder. In fact, small stones may pass out even without causing any symptoms. But, with larger stones, following symptoms may be seen:
- Back and groin pain: Severe pain in the side and back, below the ribs. This pain then may move to the lower abdomen and groin as the stone passes down the ureter. The pain usually comes in waves and fluctuates in intensity
- Pain on urination
- Pink, red or brown urine
- Nausea and vomiting
- Persistent urge to urinate
- Frequent urination
Can kidney stones lead to kidney failure or death?
Untreated kidney stones can significantly damage the kidneys and even lead to end stage renal disease (ESRD), requiring dialysis. But early detection and treatment may completely reverse the damage, even in those on dialysis. Unfortunately many a times, the kidney stones remain undetected for years, because minor symptoms are ignored/neglected and by the time the patient consults a doctor the damage becomes irreversible or only partially reversible.
How is the condition diagnosed?
Ultrasound of the kidney, ureter and bladder (KUB) is the most convenient and frequently used investigation to diagnose kidney stones. An X-ray KUB can further assist in diagnosis. However, in case the stones are small, the patient is obese or there is lot of gas in the abdomen, a CT scan is better method of diagnosis.
What are the treatment options?
Treatment is based on the size of the stones.
Smaller stones can be treated with plenty of fluids, pain medications and certain anti spasmodic drugs (pain and spasm relieving) which help in passing the stone out. But even when the symptoms disappear, it is essential to confirm whether the stone has been eliminated through an ultrasound or a CT scan.
Larger stones which do not pass out easily require medical therapy and more advanced treatments.
Sound waves: Depending on size and location of the stones, extracorporeal shock wave lithotripsy (ESWL) may be done. ESWL uses sound waves to create strong vibrations (shock waves) that break the stones into tiny pieces, making them easier to be passed through urine. The procedure lasts for about 45 to 60 minutes. It can cause moderate pain, so it is preferably performed under sedation or light anesthesia. ESWL can also cause blood in the urine, and discomfort as the stone fragments pass through the urinary tract. Depending on the size of stones, one or more sessions may be needed.
Percutaneous Nephrolithotomy (PCNL): This treatment is used for very large stones or in case where ESWL is unsuccessful. The procedure involves surgically removing the stone using small telescopes and instruments that are inserted through a small incision in the back.
Ureteroscopic Removal: Smaller stones in the ureter or kidneys may be removed by passing a thin lighted tube (ureteroscope) equipped with a camera through the urethra and urinary bladder to the ureter. Once the stone is located, special tools can snare the stone or break it into pieces making them easier to pass through the urine. A small tube (stent) may be placed in the ureter to relieve symptoms like swelling and to promote healing.
Laser Lithotripsy: Some stones cannot be treated with ESWL because of their size, location, type. In such cases, uretero-scopic laser lithotripsy may be used. In this procedure, a tiny fiberoptic camera is passed into the urinary tract through the urethra to locate the stones in the bladder, kidney or ureter. Then using laser technique, larger stone are fragmented into thousands of small pieces, which are flushed out through urine.
What are the chances of recurrence of stones after treatment?
The chances of recurrence of kidney stones are quite high. More than half people, who have had a stone in the past, will develop a new stone in their lifetime.
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