Kidney and ureteral stones are among the most painful conditions that send people to the doctor or hospital. Most of the time, people don’t know they have a stone until it moves into the urinary tract and blocks the flow of urine. Each year, almost 3 million Americans seek medical treatment and another half million end up in the emergency room because of kidney and ureteral stone problems.
According to the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC), the number of Americans with kidney stones has increased significantly over the past 30 years, yet medical researchers do not know why. The NKUDIC predicts that about 5 percent of the adult population will experience a kidney stone at some point.
Stones can form in the kidney, ureter and bladder. Stones occur more frequently in men than women, yet more women are getting them now than ever before. Men are most susceptible starting in their early 40s and the risk continues to increase well into their 70s. Women are at most risk in their 50s.
Causes of Stones Are Still Unknown
“We do know that eating certain foods is not the cause of kidney and ureteral stones,” said Allen D. Seftel, MD, FACS, Head of Urology at Cooper University Hospital. “Urinary tract infections, kidney disorders such as cystic kidney disease, and certain metabolic disorders such as hyperparathyroidism, can be linked to stone formation, but unless a person is susceptible, food is not the culprit.”
It is important to note that although, in general, foods are not a known cause of kidney and ureteral stones, people who have a history of stones may need to be very careful with their diet to prevent additional stones from forming. What foods to consume or avoid depends upon the type of stone. Foods that may help prevent one type of stone may actually cause another type of stone to form. For example, citrus drinks (orange juice, lemonade) are recommended to help avoid the formation of calcium oxalate stones, the most common stone, yet these drinks can be harmful and should be avoided when a person has calcium phosphate stones.
“Is is very important for people who have a history of stones to ask their doctor which foods are best,” explained Dr. Seftel. “Stone sufferers should also drink plenty of water every day. Water flushes chemicals from the body and can help prevent all kinds of stones.”
How Stones Form
The kidneys are bean-shaped organs on each side of the body. They remove extra water and wastes from the blood, producing urine. They help the body keep a stable balance of salts and other substances in the blood and also produce hormones that help build strong bones and form red blood cells.
Kidney and ureteral stones are a mass that develops from crystals that separate from the urine in the urinary tract. Chemicals in the urine usually prevent these crystals from forming. In some people, however, these inhibitors do not work. Medical researchers do not know why one person is more likely to develop stones than another. They do know, however, that once a person has more than one stone, there is a greater chance they will continue to develop more stones in the future.
Small kidney and ureteral stones often pass through the body without a person experiencing any pain or discomfort. When the stone is large enough to cause a blockage, the result is extreme pain. Also, stones can sometimes cause nausea, vomiting, or pain in the abdomen, back or groin. Blood in the urine is another sign a stone may be present.
Cooper Urologic Institute Offers the Latest Treatment for Stones
Many stones do not require an invasive surgical procedure. Extracorporeal shock wave lithotripsy (ESWL) treats kidney and ureteral stones from outside the body and is performed without requiring the surgeon to cut into the body. This treatment is now the most frequently used procedure in the United States for the treatment of kidney and ureteral stones.
Shock Waves Crush Stones
Cooper’s urologists perform ESWL for the treatment of all types of kidney and ureteral stones. ESWL is a non-invasive approach that breaks down stones by directing up to 3,000 waves of ultrasonic energy directly onto and into the stone, which then breaks into fragments small enough to pass via normal voiding.
“Cooper’s technology provides optimal access to stones of any size,” Dr. Seftel said. “The energy focus required to crush a stone can be perfectly matched with the size of the stone.”
ESWL is performed on an out-patient basis and takes approximately one hour. More than one treatment may be required in some cases. General anesthesia, intravenous sedation or regional anesthesia is used depending on the patient’s health and co-morbidities. Most patients can return to normal activities within a few days.
Multiple Treatment Options Available
Cooper urologists work closely with each patient and each patient’s nephrologist to identify the best treatment option. In addition to ESWL, Cooper urologists perform minimally invasive ureteroscopy (URS) – an outpatient procedure in which the surgeon passes a small scope through the urethra, through the bladder and then snares the stone with the scope and crushes it. They also perform percutaneous nephrolithotomy (PNL) for very large stones that can’t be treated with ESWL. The PNL procedure requires the surgeon to make an incision in the back and into the kidney. The surgeon then uses a nephroscope to break up and extract the stones. In extremely rare cases, traditional open surgery is required to remove stones. All procedures require some form of anesthesia, and recovery times vary for each procedure. Most major health insurance plans are accepted, including Medicare and Medicaid.
To request an appointment with Allen D. Seftel, MD, FACS