Kidney Stones Specialist

Ensuring you receive the best treatment option for you and your lifestyle

WHAT ARE KIDNEY STONES?

They can be soft, but in some instances, they can be extremely hard. Some stones are smooth and round whereas others can have rough or jagged edges. Kidney Stones can vary in size from one or 2 mm up to 5 or 6 cm or more, generally forming in the kidney and can remain there for many years without causing any symptoms or problems. If they drop out of the kidney towards the bladder, they can cause a blockage in the drainage of urine from the kidney. They will travel as far as they can and if they are small enough (less than about 4- 5 mm) they may pop into the bladder spontaneously. This can be painful but at least, you will have saved yourself more pain and an operation. If they are larger, they may get stuck at some point. The blockage causes backpressure up into the kidney which is what causes the pain known as renal colic.

Kidney stones can be composed of many different compounds. The most common is a combination of calcium and oxalate. These types of stones need to be removed as there is no medicine that can dissolve them. The next most common type of stone is made of uric acid and in some circumstances, these can be dissolved.

MEET DR. DAVID ENDE

A specialist Urologist providing consulting and surgical services at St Vincent’s, Norwest, and Blacktown.

Dr Ende’s years of clinical experience together with his commitment to ongoing research and presentations at specialist forums ensures he remains at the forefront of the most advanced technology and treatment modalities available to benefit his patients.

KIDNEY STONE SYMPTOMS

Kidney stones can remain in the kidney without causing any symptoms for many years. They may slowly get bigger but may remain asymptomatic. Stones in the kidney can be associated with bleeding or infection. The main symptom attributed to kidney stones is renal colic that occurs when a kidney stone causes a blockage to the flow of urine between the kidney and bladder.

This pain is usually experienced in the loin or flank and can radiate around the front of the abdomen down toward the pubic bone. The pain can be severe and unrelenting and can be associated with sweating, nausea and vomiting. If simple analgesia at home is insufficient, you will need to attend a local hospital where stronger pain relief can be administered after the diagnosis is made.

Plain Xray showing large calcified stones
Investigations

KIDNEY STONE INVESTIGATIONS

If you are suspected of having kidney stone pain, you will need to have a CT scan of your abdomen. This will cover both of your kidneys as well as the ureters (tubes that drain urine down toward the bladder) and the bladder. You do not need to have an injection contrast for this scan. Any stone, anywhere in the urinary tract will be identified with this scan. Other types of imaging including ultrasounds and x-rays can sometimes be used to diagnose kidney stones but these are usually not as accurate. You will also need a urine test to check for blood in the urine as well as the possible presence of infection.

PREVENTATIVE MEASURES FOR KIDNEY STONES

The easiest way to reduce your risk forming stones is to ensure a good fluid intake. This makes you pass more urine more frequently but it will keep your urine dilute and reduce the risk of stones from forming. You can tell you’re drinking enough fluid if your urine is a light pale yellow colour.

In general terms, you should have a healthy balanced diet consuming everything in moderation. There are specific foods that can be limited such as those containing oxalate. You should limit the amount of salt you consume.

Citrate, in the form of lemon juice, is an inhibitor of stone formation in the urine. Squeezing lemons into a jug of water and having a glass or two every day adds to your fluid intake as well.

Specific blood and urine tests can be utilised to measure things such as the calcium in your blood as well as the salt, calcium and oxalate levels in your urine. If these, or other metabolites, are in the abnormal range, you may need to modify your diet or take medication.

Calculus

KIDNEY STONE TREATMENT OPTIONS

If your pain can be controlled with relatively simple analgesia, and if the stone is small enough (less than 5 mm or so), you may be able to see whether you can pass the stone out on your own. Sometimes a medication can be used to help the stone come out. If however, you have more severe pain, you may well need to be admitted to hospital for strong pain relief and a procedure to look with a telescope into the bladder and up towards a kidney to destroy the stone with laser and pull out any fragments.

A very small stone in the kidney can be monitored as it would likely pass all the way into the bladder without causing problems. We do however need to monitor it regularly with a scan every year or so to check on its size.

If you have a reasonable sized stone in your kidney, you may wish to have this treated even though it may not be causing symptoms. It would be sensible to treat such a stone to avoid the possibility of untimely severe complications from the stone. Stones in the kidney can also be treated using a telescope and laser but there may also be the option to use external shock waves focused on the stone to break it into smaller pieces that you can pass much more easily without pain.

ureteroscopy laser icon

URETEROSCOPY & LASER

Stones stuck between the kidney and bladder can be treated with a laser to turn them into dust.

treatment options 2

LITHOTRIPSY

Some stones in the kidney can be treated with shock waves to fragment them which is non-invasive.

kidney stone treatment

PERCUTANEOUS TREATMENTS

Large kidney stones sometimes require a telescope to be passed directly into the kidney through the skin to allow adequate destruction of the stone in a single treatment.

Calculus about to enter bladder form ureter

KIDNEY STONE CAUSES

The most common cause of a kidney stone is probably insufficient fluid intake. This allows tiny crystals to form in the urine which then gradually become larger. Certain foods can be implicated in the formation of kidney stones such as those containing oxalates.

Foods high in oxalate include spinach, soy products, almonds and raspberries. A diet high in sodium/salt can also predispose to stone formation. It may be counterintuitive, but you should not restrict your calcium intake as this can cause an imbalance between calcium and oxalate and potentially allow more stones to form.

Please call us to arrange a consultation

KIDNEY STONE RELATED BLOGS

Should I treat my Kidney stones?

Many patients are found to have incidental stones in their kidneys that have never caused problems and such patients may never have known that they

read more

Is Blood In My Urine Serious

Many patients see their urologist because they have either seen blood in their urine or have been told they have microscopic levels of blood in

read more