Kidney Stones

Kidney stones are one of life’s most painful experiences and occur all too frequently. As many as 1 in 5 people will experience a kidney stone in their life. Many women have told me passing a kidney stone was worse than childbirth.

Why are kidney stones so awful?

Most stones form in the kidneys for a variety of reasons. While they are sitting in the kidney, they typically don’t cause any pain or problems, unless they grow very large. It’s when they begin to pass that they cause problems.

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Once the stone drops out of the kidney and into your ureter (the tiny tube that connects your kidney to your bladder) the misery begins. There are three places stones commonly get stuck while they pass: (1) just as they leave the kidney; (2) where the ureter passes over a set of big blood vessels; and (3) right where the ureter enters the bladder. Once the stone passes out the ureter and into the bladder, usually the pain is gone and often the stone can pass the rest of the way without you knowing.

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If you think you may be passing a kidney stone, you need to see a doctor immediately.

If the stone is small, and you are tolerating the pain ok, you may be given a chance to pass the stone. If, on the other hand, you have an obstructing stone and a kidney infection, the situation can be an emergency. This is why you need to see a doctor right away. If you are going to try to pass your stone, most doctors will provide pain medication, nausea meds, something to help open up the ureter (often a med called Flomax) and usually a strainer to try to catch the stone. Even if you pass your stone, you will need to follow-up with your urologist afterward.

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If your stone is too large to pass, or gets stuck, there are some options.

Each option has pros and cons. Not every patient will be given both options. You will need to have a discussion with your urologist about them to take into account stone size, location, composition, and your medical history. We can attempt to smash the stones with shock waves. This is known as an ESWL (extra-corporeal shockwave lithotripsy) and is pronounced ezzzwall by urologists, because we’re dorks and that’s easier to say than E-S-W-L. The other option is to drive a tiny scope straight up to the stone and blast it with a frickin’ laser.

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Either way, you’re asleep for the procedure under general anesthesia. Regardless of which option you choose, you may need a stent placed. A stent is a tube that connects the kidney to the bladder and protects the ureter after the trauma of a stone and a surgery. Some people don’t even know the stent is there, others have pain from the stent. Cross your fingers you’re on the lucky side of that. Once we’ve removed your stone, you may even be able to make your wife (or yourself?) a gorgeous piece of kidney stone jewelry. (I didn’t know this was a thing people did until I started researching this article.)

So, can I prevent kidney stones?

The vast majority of kidney stones, ~80%, are made of calcium. The reasons they form are complex and individual to each patient. The single greatest recommendation to help prevent them is to maintain championship hydration levels.

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There are also a few other components of your diet, and as such your urine composition, that can contribute to stones. Most calcium stones are made of calcium oxalate. Oxalate is a very common substance is many people’s diet, and limiting it can be difficult. Common high oxalate foods include leafy vegetables like spinach and kale, starches like French fries and potato chips, and most kinds of nuts. Remember, not everyone needs to limit their diet—we do not recommend you change your diet without speaking with a physician first.

On the other hand, there are substances like magnesium and citrate that help prevent kidney stones. Here’s the rub: your body can’t store either of those substances, so if you want to help prevent stones, you have to be constantly ingesting them. For over the counter stone prevention, we commonly recommend (and we at Midtown helped create) a supplement called KSPtabs (https://www.ksptabs.com/). This supplement helps maintain hydration, adjusts the acidity in your urine to help prevent stones, inhibits oxalate, and provides the citrate and magnesium to help prevent stones. All good stuff.

So, now that you understand what kidney stones are, where they come from, and what the options are, let us at Midtown Urology know what we can do to help. If you’ve had stones before, we can work with you to help prevent them in the future. Sadly, if you’ve had a stone in the past, there’s a 75% chance you’ll have another. There are people who have passed dozens of stones. This is distinctly the least enjoyable type of "stoner" a person can be. If you think you’re passing a stone, we can often see you the same day and help diagnose and treat the condition. If you’re one of the unfortunate souls who has experienced this personally, I’m sorry for making you cringe in pain for the last few minutes while you read this.

This Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Author
Midtown Urology

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