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What are kidney stones?

Kidney stones are hard deposits made of minerals and salts that form in the kidneys. They can be as small as a grain of sand or as large as a golf ball. Kidney stones can cause severe pain and discomfort, and they can also lead to complications such as urinary tract infections and kidney damage.

I have a question about kidney stone removal

Who can get kidney stones?

You’re more prone to kidney stones if you have a sedentary life, poor water intake, a diet high in protein and low in fibre, recurrent kidney or urinary infections. Renal stones can also be  associated with diabetes and some bowel disorders.

You may also be more likely to develop kidney stones if you have a family history of this condition.

What are the symptoms of kidney stones?

Symptoms of kidney stones depend on size and location. Large stones can cause loin pain, haematuria (blood in the urine) or urine infections.

Occasionally stones can drop from the kidney into the ureter (tube draining urine from the kidney to the bladder). This is known as ‘renal colic’ and can be extremely painful. If renal colic is associated with an infection, you may need emergency treatment to drain the kidney.

Smaller stones may pass spontaneously, but some may become stuck and need removing surgically.

What are the types of kidney stones?

There are four main types of kidney stones: calcium stones (the most common), uric acid stones, struvite stones, and cystine stones.

How are kidney stones diagnosed?

Kidney stones may be diagnosed with an ultrasound or x-ray, but your Consultant may advise a CT scan as the best test for diagnosis.

A urine test may also be done to check for signs of an infection or other conditions that may be causing the stones. Blood tests are undertaken to check calcium and uric levels in the blood.

If you have recurrent or multiple stones a more in-depth metabolic screen may be required.

What is the treatment for kidney stones?

Treatment for kidney stones depends on the size and location of the stone. Smaller stones (under 2.5cm) can be treated with a machine called a lithotripter. This can be carried out in a clinic setting, under simple analgesia. The machine is pressed against your loin and focusses shock waves onto the stone. The stone breaks up and the fragments will pass in your urine.

Another option to remove smaller stones is ureteroscopy, which is available at our hospital. This is usually a day case operation under general anaesthetic. A long, fine scope is passed via the urethra up to the kidney with no surgical incision required. Stones can be broken up with a laser and the fragments can be removed or, if they’re small enough, can be left to pass in your urine.

Large stones (greater than 2.5cm) usually require a major procedure called percutaneous nephrolithotomy (PCNL). This involves passing a tube directly into the kidney via the loin, breaking up the stone and removing the fragments. PCNL and lithotripsy are carried out in major renal stone centres.

Your Consultant will advise which treatment option is best for you.

What happens during ureteroscopy for kidney stones?

On the day of your operation, we may arrange for another x-ray or CT scan to confirm that the stone hasn’t changed in any way. We’ll also check for urine infections which, if present, may delay your operation. A routine pregnancy test is also undertaken due to the use of x-rays during the procedure. 

Once you’ve confirmed consent with your Consultant, the Anaesthetist will explain the general anaesthetic. They’ll also discuss post-procedure pain relief.

We’ll check you for allergies and, if it’s safe to proceed, will usually give you an antibiotic injection before your procedure. We may give you an injection of heparin, a blood thinner, and offer you anti-embolism stockings to prevent blood clots.

Your Consultant will pass a scope into the bladder via the urethra. A fine guidewire will be passed up to the kidney to guide the ureteroscope to the stone and its position is confirmed with x-ray guidance. The stone will be broken up with a laser. Some fragments may be removed, and smaller fragments can be left to pass naturally.

A plastic tube called a stent is often left in place for a few weeks after the operation to prevent any blockages. This is later removed under a quick, local anaesthetic procedure.

Does kidney stone treatment hurt?

The procedures used to treat kidney stones can cause some discomfort or pain, but simple analgesics are usually effective in managing the pain.

What happens after kidney stone removal?

Ureteroscopy, like any operation, does carry some risks such as pain, temporary bleeding in the urine and infection. If a stent has been placed, it can cause discomfort and cystitis-like symptoms. There is a very small risk of damage to the ureter. Sometimes it isn’t possible to remove all of the stone and further operations may be needed.

You’ll usually be treated as day case, although your Consultant might recommend spending one night in hospital, depending on the complexity of the procedure. They’ll advise on aftercare, which may include antibiotics. You should drink plenty of fluids for 24-48 hours after the procedure to help flush out your system and reduce the risk of blockages.

If you experience a fever, pain in your back or when passing urine or you’re unable to pass urine you should contact your GP as soon as possible.

A follow-up appointment will be made to discuss the composition of the stone, dietary changes and other possible treatment options or surveillance requirements.   

When can I return to work after kidney stone removal?

You’ll be able to go back to work once you’re comfortable enough. How long will depend on how physically demanding your job is, whether a stent has been placed and if all of the stone has been removed.

Our Consultant Urological Surgeons

Mr Garnett

Steve Garnett

Consultant Urological Surgeon

Mr Garnett's specialties include prostate disease, kidney surgery and treatments for Benign Prostatic Hyperplasia (BPH).

Mr Mackie

Simon Mackie

Consultant Urological Surgeon

Mr Mackie specialises in general urology, endourology and renal stones and male lower urinary tract symptoms.

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