Kidney stones
Most kidney stonesare small enough (less than 4mm in diameter) to be passed outin your urine and can probably be treated at home.
But even small kidney stones can be painful, although thisusually only lasts a couple of days and disappears when the stone has been passed.
If you are in severe pain, your GP can give you pain relief by injection. A second dose can be given after half an hour if you're still experiencing pain.
Medication can also be injected to treat the symptoms of nausea (feeling sick) and vomiting. This is called an anti-emetic (anti-sickness) medication.
You may also be given a prescription for painkillers, anti-emetics, or both, to take at home.
You may be advised to wait until you pass your kidney stone when you go to the toilet, and to try to collect it from your urine. You can do this by filtering your urine through gauze or a stocking.
Give the stone to your GP so that they can have it analysed to help determine any further treatment you may need.
You should drink enough water to make your urine colourless. If your urine is yellow or brown, you're not drinking enough.
If your kidney stone has moved into your ureter (the tube that carries waste products from the kidneys to the bladder), and it's causing severe pain, your GP may admit you to hospital for treatment.
This may be necessary if:
If a kidney stone is too big to be passed naturally 6-7mm(about 0.23 to 0.27in)in diameter or larger you may need treatment to remove it another way.
This could include:
These procedures are explained in more detail below. The type of treatment you have will depend on the size and location of your stones.
ESWL is the most common way of treating kidney stones that can't be passed in the urine.
It involves using ultrasound (high-frequency sound waves) to pinpoint where a kidney stone is. Ultrasound shock waves are then sent to the stone from a machine to break it into smaller pieces, so it can be passed in your urine.
ESWL can be an uncomfortable form of treatment, so it's usually carried out after giving painkilling medication.
You may need more than one session of ESWL to successfully treat your kidney stones. ESWL is up to 99% effective for stones up to 20mm (0.8in) in diameter.
If a kidney stone is stuck in the ureter, you may need to have a ureteroscopy, which is also sometimes known as retrograde intrarenal surgery (RIRS).
Itinvolves passing a long, thin telescope called a ureteroscope through your urethra (the tubeurine passes through on its way out of the body) andinto your bladder. It's then passed up into your ureter to where the stone is stuck.
The surgeon may either try togently remove the stone using another instrument, or they may use laser energy to break it up into small pieces so that it can be passed naturally in your urine.
Ureteroscopy is carried out under general anaesthetic (where you're unconscious), so you shouldn't drive or operate machinery for up to 48 hours after the procedure.
For stones up to 15mm (0.6in), a ureteroscopy is effective in 50-80% of cases.
Aplastic tube called a stent may need to betemporarily inserted inside you to allow the stone fragments to drain into the bladder.
PCNL is an alternative procedure that may be used for larger stones. It may also be usedif ESWL isn't suitable for example, because the person being treated is obese.
PCNL involves using a thin telescopic instrument called a nephroscope. A small incision is made in your back and the nephroscope is passed through it and into your kidney. The stone is either pulled out or broken into smaller pieces using a laser or pneumatic energy.
PCNL is always carried out under general anaesthetic,so you shouldn't drive or operate machinery for up to 48 hours after the procedure.
PCNL is 86% effective for stones that are 21-30mm (0.8-1.2in) in diameter.
Nowadays, open surgery for kidney stones is rare (less than 1% of cases require this type of surgery). It's only usually used if there's a very large stone or abnormal anatomy.
During open surgery, an incision will be made in your back so that your surgeon is able to access your ureter and kidney. The kidney stone can then be removed.
If you have a uric acid stone, you may be advised to drink around three litres (just over five pints) of water each day to try to dissolve it.
Uric acid stones are much softer than other types of kidney stone, and they can be made smaller if they're exposed to alkaline fluids.
Youmay need to take some medication to make your urine more alkaline before the uric acid stone starts to dissolve.
Complications can occur following the treatment of large kidney stones. Your surgeon should explain these to you before you have the procedure.
Possible complications will depend on the type of treatment you have and the size and position of your stones.Complications could include:
It's estimated that 5-9% of people may experience complications after having a ureteroscopy.
Herbal and green teas generally have lower amounts of oxalate than black tea. High amounts of oxalate can cause kidney stones, and the dietary recommendations for you would depend on the type of kidney stone that you have.
Symptoms of kidney stones include localized pain depending on the positioning of the stone, pain during urination, cloudy urine, odd-smelling urine, etc.
Methods to diagnose kidney stones are: abdominal ultra sound, blood tests to check for excess uric acid or calcium, CT-scan or X-ray, pyelography.
Non-steroidal anti-inflammatory drugs are usually used to treat and alleviate the pain, and in cases of severe pain, tramadol may be used. In the case of infection, antibiotics may be used.
Kidney stones can develop in one or both kidneys and most often affect people aged 30 to 60. They're quite common, with around three in 20 men and up to two in 20 women developing them at some stage of their lives.
Read about the symptoms of kidney stones, which usually only occur if a stone gets stuck in your kidney, if it starts to travel down the ureter, or if it causes an infection.
Find out what causes kidney stones. They're usually the result of a build-up of a substance such as calcium, ammonia or uric acid in the body.
Find out how kidney stones are diagnosed. Imaging tests, such as a computerised tomography (CT) scan, can be used to help confirm the diagnosis or locate a kidney stone.
Find out how kidney stones are treated. The treatment you'll need will depend on the size and type of kidney stone you have.
The best way of preventing kidney stones is to make sure you drink plenty of water each day to avoid becoming dehydrated.