What are kidney stones?
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, usually, kidney stones are small enough to pass with our urine but sometimes they can grow bigger and get stuck in the ureter.
There are five main types of kidney stones:
- Calcium oxalate stones: form when too much oxalate or calcium is in the urine.
- Calcium phosphate stones: These occur depending on the urinary pH level
- Struvite stones: often occur following a recurrent UTI’s.
- Uric acid stones: formed in acid urine and often 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.
What symptoms do kidney stones cause?
Some people pass kidney stones and only find out when an x-ray or a urine specimen reveals them – so they would never have known they had one! 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 – ureteric colic or renal colic. This can be very unpleasant, the classic presentation of a ureteric colic is immediate, colicky flank pain radiating to the groin, sometimes with nausea and vomiting. The pain is often described as the worst pain the patient has ever had 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 (water pipe) and visible blood in your urine. Some individuals may also have microhaematuria (microscopic blood in urine) or gross haematuria (blood that you can see).
Other symptoms of kidney stones are subtle and may need to be looked into a little deeper but with 1 in 10 people affected in the UK, this is a common condition so it’s important you know what symptoms to look out for:
- 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 they diagnosed?
If your doctor 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 specialist (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: uses sound waves to create an image of the kidney and any stones therein.
- When you see Ken Anson, imaging and the diagnostic tests will be tailored to the individual patient.
How do we treat them?
90% of ureteric stones will pass spontaneously and are now 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 or those that are causing the patient unremitting pain or if there is evidence of superadded infection or a stone in a precious kidney which would be a patient who suffers from a single kidney and needs that kidney stone treating to prevent any possible deterioration in renal function.
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 it. This could include:
- ESWL – extracorporeal shock wave lithotripsy: 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 a recurrent kidney stone formation and it’s said that 30-50% of the population will experience a second episode of kidney stone disease in 5 years.
Mr Anson offers same-day appointments and scanning to establish an immediate diagnosis. Using some of the best testing and treatment facilities available in the UK, an expert radiologist will be waiting to report on the scan, which in some hospitals and clinics can take much longer. We pride ourselves in being able to offer a seamless patient experience and even 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
This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.