What causes kidney stones (Urolithiasis)?
Written by:Kidney stones are very common, they occur in approximately 15% of men and 10% of women at some stage during their lives and they mostly affect people aged 30-60 years old.
Smaller kidney stones may go unnoticed and be passed out painlessly in the urine, yet it is common for a stone to block a part of the urinary system such as the ureter (the connecting tube of the kidney to bladder) or urethra (the tube that urine passes through).
Symptoms of kidney stones
Patients should see a urologist if they have any of the following persistent conditions:
- Abdominal pain
- Blood in the urine
- Nausea and vomiting
- Urinary tract infections
- In more advanced cases kidney failure could occur.
Cause of kidney stones
Kidney stones form as a hard, crystalleine mineral within the kidney or the urinary tract. There are numerous risks for forming kidney stones, including simply not drinking enough fluids and certain medical conditions such as obesity, diabetes and hypertension. Family history of kidney stones, unhealthy dietary habits, Crohn’s disease and bariatric surgeries such as gastric bypass are also amongst the risks.
How are kidney stones treated by a specialist?
Treating kidney stones depends mainly on both the stone size and location, which will be determined with specific scans. Some cases will need additional tests in the form of metabolic work up and 24-hour urine collections to look for certain abnormalities that could increase the stones recurrence risk.
In general, smaller stones have a high chance of spontaneous passage and you would initially be advised to increase your fluid intake in addition to using pain killers whenever needed. Larger stones would usually require treatment which could be in the form of:
- Extracorporeal Shockwave Lithotripsy (ESWL) - a non-invasive procedure, where the patient lies on a water-filled cushion and the specialist uses ultrasound and X ray to locate the stone. High-energy sound waves pass through the body and break the stone into small pieces, which then move through the urinary tract and out of the body.
- Ureterorenoscopy and laser stone fragmentation - a telescope is passed through the urethra (water-pipe) to reach the ureter and kidney.
- Percutaneous Nephrolithomy (PCNL) - this is a key-hole surgery which is performed to treat the larger and more complicated kidney stones.
Are kidney stones likely to return?
Those who have developed one stone are at approximately 50% risk for developing another stone within the following 5 to 7 years. Therefore following treating the initial stone, lifestyle modifications including certain specific dietary and fluid advice is important in reducing the chances of future recurrences.
