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Kidney Stones

Kidney stones are hard substances that may be found in the kidney, ureter or bladder.  They are common – about one in ten Americans will have a stone during their lifetime.

The symptoms of stones depend upon their location.  Stones located in the kidney may be asymptomatic. Stones in the ureter can produce severe upper back pain radiating to the side or front. Lower ureteral stones may cause urinary frequency or urgency. Stones in the bladder may cause painful urination.

There are several ways to treat a kidney stone.  Most ureteral stones, 5 mm or less in size, will pass on their own without intervention.

*Introducing Dr. Lazare

For stones over 5 mm, there are three major procedures.  For stones less than 20 mm in size, the best treatment is Ureteroscopy and Laser Lithotripsy. After the patient is anesthetized, a small fiber-optic telescope is placed into the ureter and even into the kidney, if necessary.  The stone is visualized and disintegrated with the holmium laser.  The small fragments can then be removed with a tiny basket.  The risks are low and the procedure is usually performed as an outpatient.  *Stone free rates are about 85% – 90 %.

There are three basic types of stones.

Calcium stones are the most common.  They have many different causes including increased dietary calcium intake, hyper-parathyroidism, weight loss surgery, increased oxalate consumption, and inflammatory bowel disease.

Struvite stones, on the other hand, are caused by infection.  They are common in patients with spinal cord injury.

Uric acid stones are often caused by increased protein consumption and by gout.

fermale incontinence

Extra-Corporal Shock Wave Lithotripsy, or ESWL is the least invasive means of treating stones in the kidney or in the upper ureter. The patient lies on a table and shock waves are then focused upon the kidney stone. The lithotripter machine is outside the body and the procedure is completely non-invasive. The lithotripter effectively disintegrates the stone into small pieces. The patient must then pass all the stone fragments out of the urinary system via the urine. *The stone free rate with ESWL is in the 50 % to 60% range. *The procedure is low risk.

Percutaneous Nephrolithotomy or PNL is performed upon patients with stones larger than 20 mm. A small tube is placed into the kidney through the back. A fiber-optic telescope is then passed through the back and into the kidney. The stone is seen and broken with an instrument that creates mechanical shock waves. The stone fragments are then removed with suction.

Short of open surgery, the PNL is the most effective procedure for the removal of large kidney stones. *The success rate for the percutaneous procedure is over 85 %. The risks include bleeding and infection.  *In experienced hands, the risks are low.

*Please take a look at the following video. The video demonstrates the treatment of a stone within the ureter with the Holmium Laser.