Dr. K Rao

Hi, I am Dr Sarwar Eqbal. I am Urologist and I hav done MBBS in the year 1999, MS in General surgeon in 2002. Later I have done snior residency in Urology from reputed Insitute of Delhi. Then I have done the urology in kidney transplant in Sir Gangaram Hospital, Delhi, in the year of 2008. I am working as a consultant urologist from last 8 years. And I would have attached to reputed hospitals in the Delhi NCR region.

Today I am going to talk about the major problem which people are facing in Delhi, that is, Urolithiasis or Kidney stones. The kidney stone issue has become very commonin the Delhi-NCR region. Out of 8-10 cases of OPD, we a can see 5-6 cases of kidney stone, and it is more common in male. The most common cause we see is an inadequate hydrateion body because of which there occur crystallization of urine which sediments in kidney and become stones later on. So , you have to be more carefull about your health. This kind of problem is very common in summers because of the sweating, there is a lack of water in the body which gets precipitated in the kidney and takes the shape of a stone.

Stone is one of the common cause of destruction or damage of the kidney world wide. So, what we do in case of the kidney stone?

The first thing is the awareness. They should know the cause of kidney stones, or how it can be checked or prevented. So, keep yourself hydrated throughout the summer. You are supposed to have that much amount of water which can make you produce atleast 2 litres of urine pe day.

In certain cases, it is very common amongst the family. May be in the family, or may be related to some kind of food which is very common, specially the non veg which may cause urinary stones.

Now, let us come to the different kind of stones which is vry common all around India;

• Oxalate stone
• Ureteral stones and the other stone

Now, what does these Kidney stones cause?

These types of stones are formed in the kidney and they grow with time and they can take the size of the stone, ehrein they are called size of the kidney. So they start forming in the kidney. If proper precautions are not taken , they can take the shape of the kidney and can enlarge to the kidney size. This is called staghorn calculus, which can cause complete destruction of kidney and leads to kidney failure. When the stone size is small, they can cause obstruction of the kidney at certain point, like the pigeon of the kidney is the common cause of obstruction, which leads to swelling in the kidney, pain, infection. If it is not treated on time, it can cause complete damage to kidney permanently. They can trickle down to uretor. Uretor is a line that connects kidney and the urinary bladder. So, they can obstruct the uretor at any point of kidney upto the bladder level. This can cause urinary chronic which is a severe pain associated with Nausea, vomiting, burning sensations and also sometimes can cause blood in the urine. If it is not treated on time, it can lead to complete destruction of kidney.

Sometimes these stones enetrs the urinary bladder and can choke the urethera. Due to this, patients may have some problem in passing urine, which is called obstruction of the retention of urine for which we may require catheterization and later the removal of the stone.

What are the modality in the treatment of kidney stones?

The modalities depends on the size of the kidney stones as well as the location of the stones. The other parameters like the diabetes, hypertension, CADS related conditions with the patients.

The size and position of the stone. 

The management depends on the stone size and the location. If the size of the stone is < 1 cm and lies anywhere inside the kidney. Then the treatment procedure is very simple, which is known as ESWL lithotripsy. It requires some small waves targeting the stones which makes the stone pulverised (sand like) and expelled out through the urine itself. But if the stone size is big, like more than 1 cm or 1.5 cm, then the choice of treatment will be miniperc. And if the size of the stone is < 1.5 cm and the patient is not ready for ESWL. Because ESWL requires some staging, then the other great option is RIRS, which is known as the Retrograde Intrarenal Surgery.

In RIRS, we put the endocscope through urinary passage and break the stone through laser. The fragments are taken out from the kidney itself. The patient does not require any kind of incision, not even the button hole incision. When the stone is inside the ureter, then the treatment of choice is URS, which is called Ureteroscopy. If the stone is inside the bladder, then the treatment procedure will be Laser lithotipsy. In this process, we pass the endoscope through the bladder and pulverise the stone and take out the fragments through it.

If you have any such problem. Like stones in the kidney or ureter or bladder, you can contact me through Lybrate.

Thank you.