STONE DISEASE

Background

The treatment of kidney stones depends on numerous factors – size of stone, position of stone, stone composition and surgical expertise. Most stones are composed of calcium but may also be uric acid in nature or made of Struvite or more rarely Cystine .

Stones may cause severe pain, infections or bleeding. Stones in the kidney less than 4mm can be observed. If such stones pass into the ureter (the tube leading from the kidney to the ureter) most will pass through although usually cause quite a lot of pain.

Treatment Options

If stones do not pass through spontaneously, they may be treated in a variety of ways. Techniques include

• Lithotripsy – External shock wave treatment to fragment the stone from outside the body
• Ureteroscopy with Laser / stone extraction – using a long fibreoptic telescope to reach the stone and allow it to be pulled out directly of destroyed with laser
• Percutaneous Surgery for large kidney stones using direct access through the body wall into the kidney

Stones are sometimes very difficult to treat and may require repeated treatments to safely gain access up the ureter. The decision on which approach will be discussed with you to gain the best outcome. Commonly, a small tube is left inside for several weeks to assist drainage and settle swelling and to allow better access. This is called a stent and is removed with another cystoscopy after several weeks.

Preventing Stone Formation In The Future

When your stones are cleared the fragments are generally sent to pathology for evaluation and a plan is formulated to minimise further stone formation in the future. Most people form stones due to under-hydration or dietary imbalance especially related to excessive Calcium intake in dairy products. Correcting these factors can dramatically reduce the future recurrence rate of stones. Mr Donnellan will guide you through the best treatment of your stone and the best strategies available to prevent stones reforming.