Kidney stones | Ken Anson

Kidney stones are a common condition, with one in 10 people affected in the UK. Kidney stones are crystallisations of metabolites in the urine that congregate together and create stones. They look like small pieces of gravel and they come in a number of different colours and consistency, from small soft stones that can almost crumble in your hand to very hard and solid.

Our kidneys have the job of removing any waste products from the blood which are passed from our body when we urinate. The majority of kidney stones are small enough to pass with our urine but sometimes they can grow bigger and become stuck in the ureter.

There are five main types of kidney stones:

Calcium oxalate stones: These form when too much oxalate or calcium is in the urine.
Calcium phosphate stones: These occur depending on the urinary pH level
Struvite stones: These often occur following a recurrent UTIs.
Uric acid stones: These form when there is too much uric acid in the urine.
Cystine stones: These are the rarest type and are associated with a condition called cystinuria.

Symptoms of kidney stones

Some people pass kidney stones without realising and only find out they have one when an X-ray or a urine specimen reveals them. However, when a kidney stone moves down from your kidney into your ureter (the tube carrying urine from the kidney to the bladder), you may get severe pain without any warning, called ureteric colic or renal colic. This classic presentation of a ureteric colic is immediate, flank pain radiating to the groin, sometimes with nausea and vomiting. The pain is often described as the worst pain the patient has ever experienced.

When the kidney stone gets close to your bladder, you may get a constant need to pass urine although there is nothing to pass. This is due to the stone irritating the base of your bladder and fooling it into thinking that it is full. A kidney stone in this position can also cause burning when you pass urine, pain at the tip of your penis or urethra and visible blood in your urine. Some individuals may also have microhaematuria (microscopic blood in urine) or gross haematuria (blood that you can see).

Symptoms to look out for include:

Lower back or stomach pains
Blood in the urine
Nausea or vomiting
Frequent urination
Burning sensation when urinating
Pain in the tip of the penis

How are kidney stones diagnosed?

If your GP suspects you have a kidney stone they may conduct a couple of tests:

Urine test to check for infections and blood
A blood test to check kidney function, calcium and uric acid
Examination of any stones passed

If you’re referred to a urologist because of a suspicion of kidney stones, they may do further tests. These might include:

CT scan: This is a series of x-rays to build a complex picture.
Ultrasound: This uses sound waves to create an image of the kidney and any stones therein.

When you see Mr Ken Anson, imaging and diagnostic tests will be tailored to your individual circumstances.

How are kidney stones treated?

Most kidney stones, ( called ureteric stones if they move into the ureter from the kidney), will pass spontaneously and are managed with supportive measures such as pain relief and medication. The kidney stones that do need treatment are those that are too large to pass spontaneously, those that are causing the patient unremitting pain, where there is evidence of superadded infection or there is a stone in a precious kidney (where a patient has only a single kidney).

You may be admitted to hospital if you’re in severe pain or if you have a superadded infection. Large ureteric stones (5mm or larger), are often too big to pass naturally, so may require treatment to remove them.

Possible procedures to remove stones include:

Extracorporeal Shock Wave Lithotripsy (ESWL)

This is a minimally invasive treatment that involves using ultrasound or x-ray to pinpoint the stone before shockwaves are directed at the stone to break it up into smaller pieces to be passed naturally. Depending on the stone this can be done in one session or multiple sessions.

Ureteroscopy

This involves passing a ureteroscope (long thin telescope-like camera) from the urethra into the bladder and along the ureter to reach the stone. The surgeon may then use a laser to break the stone into a smaller piece to pass naturally or remove them all at the time.

Some patients are susceptible to recurrent kidney stone formation.

Mr Anson offers same-day appointments and scanning to establish an immediate diagnosis. Using some of the best investigation and treatment facilities available in the UK, an expert radiologist will be waiting to report on the scan, which can take much longer in some other hospitals and clinics. We pride ourselves on being able to offer a seamless patient experience and will try to accommodate same-day emergency treatments, such as shock-wave lithotripsy.

If you would like to speak with Mr Anson about your condition in more detail, please do not hesitate to contact us.