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Dr. P Leela Krishna

Urologist, Chennai

650 at clinic
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Dr. P Leela Krishna Urologist, Chennai
650 at clinic
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My favorite part of being a doctor is the opportunity to directly improve the health and wellbeing of my patients and to develop professional and personal relationships with them....more
My favorite part of being a doctor is the opportunity to directly improve the health and wellbeing of my patients and to develop professional and personal relationships with them.
More about Dr. P Leela Krishna
Dr. P Leela Krishna is a trusted Urologist in Kilpauk, Chennai. You can visit him at Lifeline Rigid Hospital - Kilpauk in Kilpauk, Chennai. Don’t wait in a queue, book an instant appointment online with Dr. P Leela Krishna on Lybrate.com.

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Lifeline Rigid Hospital - Kilpauk

No 47/3, New Avadi Road,Kilpauk. Landmark: Opp To Pachaiyappas College, ChennaiChennai Get Directions
650 at clinic
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How Do Kidney Stones Form?

DNB (Urology), MS (Gen Surgen), MBBS
Urologist, Faridabad
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Hi!

I’m Dr. Tanuj Paul Bhatia, senior consultant of urology at Sarvodya hospital, Faridabad.

So I will discuss what is urology? And mainly about kidney stones today. Urology is a branch of medicine which deals with male and female urinary tract and male reproductive organs. Basically in this we deal with the kidneys, where it is formed and then it comes to ureter and through the ureter it comes to the bladder and then it does empties through urethra and comes out of the body. So this is our entire urinary system and the diseases of this entire system is dealt by urologist i.e. us. So when we come to kidney stones we know that kidney stone is a very common disease, it is highly prevalent in almost whole of entire north India and states like Punjab, Haryana, Delhi and Rajasthan. They form part of stone built of India and stone built of the world. That is mainly because in this regions the temperatures are very high mainly due to summers and water consumption is not enough and most of the people tend to be dehydrated which is also occurring in the formation of kidney stones. Now if we come to etiology of kidney stone that is why our kidneys stones formed? In some people it is because the condition is genetic, they have parents or grandparents who were the stone former so the genes are passed on and they have the tendency of formation of stones. Sometimes there are patients who have other diseases which can lead to stone formation or sometimes during treatment e.g. some forms of bilateral surgery or excessive dieting can also lead to the formation of kidney stones most of the patients, however, do not have a specific reason of stone formation and they are etiologic stone formers. When it comes to symptoms of kidney stones, most common symptoms of kidney stone is pain and the pain is very typical, patients usually typically complain of back pain which rotates either from back to front or lower part of abdomen or from lower part of abdomen to the back. And sometimes male can experience pain in the scrotum and females can experience pain in the vulva region as well because of the kidney stone when they are obstructing. Having said that it is rather ironical sometimes bigger stones can actually be asymptomatic and detect on investigations done on the other purposes. So when it comes to diagnosis of kidney stones most useful entity to us for diagnosis is ultrasound.

Ultrasound is a non-invasive test and it offers them as a screening test. For urologist it is a examination of a clinical examination, it is the extension of the clinical examination. So most of the times stones are identified on ultrasound and when required we do the CT scan to further confirm the size and location of kidney stone as well as the density i.e. how hard is that stone. And these tool examination mainly form are basic outcomes. So when it comes to treatment of kidney stones the treatment of kidney stones depends on the size of the kidney stones, the location of the kidney stones and whether it is causing any complications. So when we talk about size it has been seen in most of the studies that stones that are lesser than 6mm have good chance of passing out by itself. So we always try conservative approach for these patients and we keep them on medications. Most of the patients that is about 80-90% of the patients who develop the pain due to stones have small stones and they do not require any surgery and they will pass out the stones with themselves with some additional medicines which will keep them pain free and their ureter to relax and in turn helps the stone to pass out themselves. When the stones is bigger than 6mm the chances of passing out spontaneously decrease. As the sizes increases further the chances decreases further. Similarly if the stone is tuck in the upper part of the urinary tract the chances of passing out spontaneously are less however if the stone is tuck in the lower part of urinary tract the chances of passing spontaneously is good. So third thing is complications, so whenever there is stone and it is causing recurrent urinary tract infection or it is causing fever or it is cause disengagement of the renal functions then it requires urgent treatment and it has to be removed. When we talk about surgeries of kidney stone there are different types of surgeries. So when the stone is in the kidney itself basically we can do 3 types of surgeries. One is ESWL or lithotripsy. In ESWL the patient is made to lie on a bed and some shock waves are applied to this part of the abdomen and they help the stones to break. However disadvantages of ESWL is that the success rate is relatively poor when compared to other modalities and they usually requires repetition.

So then came the era of PCNL. PCNL is the procedure which is called as percutaneous nephrolithotomy. In this the hole is made at the back and into the kidney and endoscope is passed into the kidney and stone is broken and removed. So it is a very good techniques but nowadays it is prefer only for very large stones and the latest technique in treatment of kidney stones is RIRS which is retrograde intrarenal surgery. In RIRS we basically go through a normal urinary tract and that is we go through the urethra up into the bladder and through the ureter we go into the kidney. And with this flexible urethroscope we break the stone there and there in the kidney itself, we make it into a very fine dust like substance and then we put it in a stand and come out. So most of the time this dust clears has ureter dilates because of the strand. However it has its own limitations specially when there is a very large stone e.g. stones larger than 2cm you may require multiple sitting of RIRS but for stones less than 2cm RIRS is now the preferred procedure. It is also preferred when the kidney is located in the abnormal position like in the pelvis or it is the malrotated kidney because when the kidney becomes difficult to approach via other modalities and but flexible endoscopy or RIRS we can reach it and we can break the stone then and there. When it comes to stone in ureter there are 2 modalities that are used to treat.1 is ureteroscopy which is a straight reject stereoscope and it is used to access the ureter and the stone is broken and removed. When the stone is in the upper part of kidney again there is a high chance of reproduction. Retrobuction is passing out the stone back into the kidney so if it is going back into the kidney the advantages of RIRS comes in, we can pass the flexible ureteroscope through the same route going into the kidney and break the stone which is retro pass back into the kidney. When it comes to bladder stones there are 3 procedures which are done one is cystolitholapaxy, then cystolithotripsy, and percutaneous cystolithotripsy. It depends on the size of the stone that which procedure will be done. If the stone is not very big it can be crush using a special forceps which is called as cystolitholapaxy. If the stone is between 1-5 cm then it can be broken through the normal urinary tract to transvaginal cystolithotripsy. If the stone is very big a small tract is made in the upper pelvic area and the stone is fragmented and removed.

Thank you!

2873 people found this helpful

Are there any major consequences to worry about for undergoing a PCNL surgery for kidney stone removal? BP, Sugar and all other vitals normal for a 90 KG/5 Ft4 in 59 years old man.

BAMS, MD Ayurveda
Sexologist, Navi Mumbai
Are there any major consequences to worry about for undergoing a PCNL surgery for kidney stone removal? BP, Sugar and...
I am recommending you an following remedy which will surely help you 1. Take 60 gm kidney beans 2. Add 4 L of water 3. Heat for 4-5 hr 4. Strain the liquid through a fine muslin cloth 5. Allow the liquid to cool 6. Drink 1 glass of this liquid once every 2 hr in a day 7. Do this for a week 8. Do not use the liquid or the beans again 24 hr after the 1st preparation Causes: • Crystallisation of chemicals and minerals present in urine leads to kidney stones surely you will get results.
1 person found this helpful

I am Having a sudden forceful urge to must urinate. If held back dripping starts. I am healthy taking no medicine and 67+ years old. Is it a sign of Prostrate Enlargement? Any natural remedial measure?

Diploma in Clinical Nutrition, Certified Diabetes Educator, Diploma in Sport & Exercise Nutrition, Diploma in Human Nutrition, Lifestyle Medicine, BSC IN LIFE SCIENCES
Dietitian/Nutritionist, Bangalore
I am Having a sudden forceful urge to must urinate. If held back dripping starts. I am healthy taking no medicine and...
Yes. Please get it checked. Also please reduce or stop all white sugar based products, packed foods and take more natural foods. Dates & flaxseeds are considered beneficial for prostate enlargement.
1 person found this helpful

I tested my urine. Test result was Pus cells 2-4/HPF. EPITHELIAL CELLS 2-3/HPF. Is it indicates urine infection?

MBBS, DNB - Internal Medicine
Internal Medicine Specialist, Mumbai
I tested my urine. Test result was Pus cells 2-4/HPF. EPITHELIAL CELLS 2-3/HPF. Is it indicates urine infection?
Not at all. Is there burning urine symptoms? Fever?males ideally shdnt have any pus cells in urine but up to 5 pus cells is normal in women and also in males if without any symptoms. Hav plenty of water. Btw are you a diabetic?
1 person found this helpful

Hi sir / madam I Naresh I am 27 years old I am suffering diabetes since 6 months before post 160/110, and urin 0.5 and after post launch 245/160, urin 1 please tell how to control and food details.

MBBS, CCEBDM, Diploma in Diabetology, Diploma in Clinical Nutrition & Dietetics, Cetificate Course In Thyroid Disorders Management (CCMTD)
Endocrinologist, Hubli-Dharwad
Hi sir / madam I Naresh I am 27 years old I am suffering diabetes since 6 months before post 160/110, and urin 0.5 an...
Hi it is very important to take appropriate drugs to control blood sugar and then also take restricted diet that gives exact calories based on ideal body weight, sugar levels and extent of daily exercise. To give a specific diet plan your present dietary pattern and extent of exercise daily are to be known, because diet for a diabetes patient is very individual specific. In the mean time avoid sweets, deep fried foods, junk foods, pastries, sweetened aerated drinks, high fat milk products, fructose corn syrup containing products, highly processed foods and alcohol. Consume more of green leafy vegetables, salads and permitted fruits about 100 g a day. Plus exercise daily for at least 1 hour.
2 people found this helpful

Do drinking beer in moderate quantity (300 ml per day) for a moderate kidney stone (7 mm) is beneficial to reduce the stone size in appreciated amount over a certain period of time?

MBBS Bachelor of Medicine and Bachelor of Surgery, MS - General Surgery, Genito Urinary Surgery
Urologist, Ludhiana
Do drinking beer in moderate quantity (300 ml per day) for a moderate kidney stone (7 mm) is beneficial to reduce the...
No it is not. It will just be a diuretic which can increase your urine output. Drink ,4-5litres of fluid which can include 300 ml of beer also but it will not decrease the size of the stone.

I am 49 yes of age. I have stone of 5.4 mm in mid ureter. No pain now. Drinking lot of fluid. Can it be passed on own or with medicine.

MBBS Bachelor of Medicine and Bachelor of Surgery, MS - General Surgery, Genito Urinary Surgery
Urologist, Ludhiana
I am 49 yes of age. I have stone of 5.4 mm in mid ureter. No pain now. Drinking lot of fluid. Can it be passed on own...
Take cap dynapress 0.4 mg once daily and drink plenty of fluid daily around 4-5 litres. It should come out.

Hi sir my name is prasad My problem is kidney stones 3 month back test reports Left 4m Right 6m already I am using English medicine Homeopathy But not clear stone Pls tell me good medicine.

Bachelor of Ayurvedic Medicines and Surgery(BAMS), Post Graduation Diploma in Emergency Medicines And Services(PGDEMS), MD - Alternate Medicine
Ayurveda, Ghaziabad
Hi sir my name is prasad My problem is kidney stones 3 month back test reports Left 4m Right 6m already I am using En...
Take 1 cup of horse gram + Add ½ L water + Heat the mixture till water level reduces to 1/5th + Strain and collect the soup + add 2 tsp of crushed pomegranate + Mix well + Drink once a day. Take shool gaj kesari ras twice a day. Take gokshuradi guggul & punarnavadi mandoor 1-1 tab twice a day. Pranacharya U through capsule and syrup twice a day. Drink lots of water. Avoid spinach. Tea and coffee. Tomato.lady finger etc.

Can I eat urimax and pyridium 200 together? I had problem passing urine so doctor asked to take urimax and get rgu and MCU done. Had a lot of burning after tests, so radiologist suggested to take pyridium 200.

MS - General Surgery, FMAS.Laparoscopy
General Surgeon, Gandhinagar
Can I eat urimax and pyridium 200 together?
I had problem passing urine so doctor asked to take urimax and get rgu an...
Hello dear Lybrate user, Warm welcome to Lybrate.com I have evaluated your query thoroughly. Both can be taken together without any problems Hope this clears your query. Wishing you fine recovery.
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