What causes kidney stones (Urolithiasis)?

Written by: Mr Tamer El-Husseiny
Published: | Updated: 30/11/2018
Edited by: Top Doctors®

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.

Mr Tamer El-Husseiny

By Mr Tamer El-Husseiny
Urology

Mr Tamer El-Husseiny is an experienced consultant urological surgeon based in London, who in addition to general urology sub-specialises in the diagnosis and management of kidney stones and benign prostatic disorders. He is an expert in endourological surgery (minimally invasive surgery) such as ureteroscopy and laser stone fragmentation, PCNL (keyhole surgery for kidney stones), HoLEP (Holmium Laser Enucleation of the Prostate), Urolift, Rezum water vapour (steam) therapy and the endourological management of upper tract urothelial cancers. He treats other upper tract abnormalities, including ureteric strictures and obstruction and has special expertise in the use of different types of urological stents.

Mr El-Husseiny graduated from medical school with honours before completing his basic surgical and urological training and was appointed as an assistant lecturer in urology. Mr El-Husseiny underwent his higher specialist training on both the London and West Midlands urology training schemes, and completed the prestigious two year subspecialty endourology fellowship at St Bartholomew’s Hospital, London (Awarded by the Endourological Society, USA), specialising in the management of complex stone disease. He has completed an MSc and an MD degree in urology and has a passion for research and academic urology.

He has led and completed many research projects and has extensively published in peer reviewed journals, authored book chapters and presented at international, national and regional conferences. Mr El-Husseiny is also a peer reviewer for numerous international journals and always maintains a strong teaching interest and has taught on numerous courses and workshops.


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