I am Dr. Harbinder Singh, Urologist. Today I will talk about the kidney stones. Kidney stones deposited on the surface of the kidney. It is common in all age groups and more common in males compared to females. How kidney stones patients are present to us? Most of the patients ae present to use with sudden pain with very associated nausea and vomiting. Some times the patient has hematuria. Sometimes symptoms will be as similar as urinary tract infection. What are the causes of renal stones? Most of the causes are related to dehydration. And the 2nd important cause is the pH of the urine. Some of the diseases which are associated with kidney stones are gout, parathyroid, and urinary tract infection. Some of the factors which cause an increased risk of kidney stones are family history, high protein diet, sedentary lifestyle and extremely high outdoor activity. The common types of stones which occur are calcium oxalate stones, cysteine stones, uric acid stones and some of the stones are associated with medicines. If timely not treated, the patient has to get admitted because of recurrent pain.
The patient may also suffer from renal failure. Once the patient is present to us with the symptoms, we need to investigate the patient. We have to do some blood tests and urine examination. Urine examination will also show the presence of red blood cells in the urine. Ultrasonography is also easily available and we can easily pick-up the stones of the kidney. But may not be able to pick up the stones which are present in the ureter. Therefore, the patients who are present with the sudden onset of the severe pain should undergo the non-contra city scan of the kidney ureter bladder region which is the gold standard modality to diagnose the renal stone. A CCT in addition to confirming the diagnosis gives us a lot of information which tells the size of the stone, the degree of the dilatation which is occurring in the kidney because of the stones. All kidney stones need treatment. The exact and accurate modality will depend upon the location of the stones and the size of the stones. Very small stones can be treated with the help of the medical therapy which includes the tests of the urine, adequate hydration.
Sometimes it requires surgical intervention. These days many surgical modalities are available and negligible modalities for the patient. For the kidney stones, the most common variable modalities include percutaneous, PCNL, renal surgery. Now how to select the appropriate modality for the treatment. There are certain guidelines for that. There is a different kind of treatments for the stones less than 2 cms in size. For the stones more than 2 cms in size, PCL is the best treatment. Uric stones, again the treatment depends upon the size of the treatment. Stones less than 5 mm, medications can be given to dissolve them. Painkillers can also be given. Large uric stones are treated with the help of endoscopic surgery and in the form of URS. The commonly asked question is how to prevent the occurrence of the stones. The most important aspect in the prevention of the stones is adequate hydration. One should take plenty of liquid in the form of plain water, lemonade at least 3-3.5 liters per day One should avoid excess salt intake. Those who are taking excess salt in the diet are prone to get kidney stones. One should cut down animal protein as it also causes kidney stones. With dietary modification and the patient with renal stones has to take the precautions which I already told. Those who have recurrent stones formation, the dietary modification will depend upon the analysis of the precious stone and metabolic analysis.