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What is Kidney stones?

Kidney stones or renal calculi are hard masses of salts and minerals that form in the kidneys. Kidneys filter waste products and expel them from the body through urine. When the concentration of toxic waste in urine is more than the fluid, the waste clumps together to form renal stones. Kidney stones can be as small as a grain of sand or as big as a ping pong ball. When kidney stones form around the urinary tract, they can cause obstruction during urination, causing immense pain. Hence, it is very important to seek medical consultation if you are experiencing symptoms of kidney stones.

Causes

  • Obesity
  • Heredity
  • Less consumption of water
  • High consumption of food containing animal protein
  • Excess calcium supplements
  • High intake of sugar and salt contents

Symptoms

  • Nausea
  • Vomiting
  • Blood in urine
  • Immense pain in the abdominal area
  • Burning sensation during urination
diagnosis

Diagnosis

The urologist conducts several diagnostic tests to determine the location, number, and size of the stones. Several tests help the urologist for the precise nature of the condition. Some of the diagnostic tests recommended by the urologist are -
  • Imaging tests - These tests include x-rays, abdominal ultrasound, or an MRI to obtain images of the abdomen and
  • Blood tests - This helps the urologist examine the contents of blood and check for any signs of calcium, phosphorus, uric acid, and electrolytes.
  • Blood urea nitrogen (BUN) and creatinine - This test indicates any abnormal kidney functioning and measure the increased nitrogen amount in the blood.
  • Urinalysis - This test is done to assess urine contents to indicate any crystals, bacteria, urinary tract infection, etc.
Services

Surgery

The treatment for kidney stones depends on the size, number, and location of the stone. Renal stones of size less than 4mm usually do not require any surgical procedures and can be flushed with excess water and medications. However, stones larger than 4-5mm require surgical procedures. There are four surgical procedures to remove kidney stones -
  • URSL (Ureteroscopic Lithotripsy)
  • ESWL (Extracorporeal Shock Wave Lithotripsy)
  • RIRS (Retrograde Intrarenal Surgery)
  • PCNL (Percutaneous Nephrolithotomy/Nephrolithotripsy)
diagnosis

Cost

The cost of kidney stones surgery in Madurai varies depending on the patient’s profile, choice of kidney stones surgeon, choice of hospital, kidney stone doctor’s consultation fee, choice of surgery, number, size, and location of the stones, cost of non-medical items, post consultation charges, etc. Contact KidneyStonesDoctor for more information on the price range for different surgical procedures in Ranchi. Following is the price range for kidney stone treatment -
  • URSL- Rs. 40,000 - Rs. 65,000
  • RIRS- Rs. 95,000 - Rs. 1,05,000
  • ESWL- Rs. 40,000 - Rs. 50,000
  • PCNL- Rs. 65,000 - Rs. 75,000

URS (Ureteroscopy) - 

  • Ureteroscope is passed through the urethra and into the ureter to remove the stone. 
  • The surgeon inserts a thin tube with a camera and light on the tip. 
  • Laser breaks the stone or stones into fragments which are either taken out or allowed to flush out through the urine. 

ESWL (Extracorporeal Shock Wave Lithotripsy) -

  • Uses shock waves to break the kidney stone into small pieces so that you can pass it through your urine. 
  • Done under local or general anesthesia. 
  • The surgeon locates the stones via X-ray or an ultrasound, and a gel-filled cushion is put on your abdomen. 
  • The cushion transmits sound waves to the stone, breaking it up into smaller pieces. 

RIRS (Retrograde Intrarenal Surgery) - 

  • Done using a flexible ureteroscope for larger stones.
  • Performed under the influence of anesthesia. 
  • The urologist will use an endoscope, a thin, flexible tube to reach the bladder through the urethra to identify stones and blast them with a laser. 

PCNL (Percutaneous Nephrolithotomy) -

  • The surgeon uses this technique for minimally invasive surgery. 
  • Large kidney stones are removed through a small incision in the skin, and a tube with a camera and light on the tip is inserted. 
  • Imaging tests are done again to check for the results.

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    The treatment procedure for kidney stones is majorly based on the size, number, and location of the stones. Kidney stones treatment involves two types of procedures – invasive and non-invasive surgery. There are overall four surgical procedures for the treatment of renal calculi or kidney stones – 

    1. RIRS (Retrograde Intrarenal Surgery)

    • Treated for stones size between 8mm to 15mm. 
    • The patient is under general anesthesia. 
    • The urologist uses a thin, flexible ureteroscope to locate the stones. 
    • The stones are broken into smaller fragments with a tiny laser and expelled through urine. 
    • Stents are inserted through the urethra all the way to the ureter to enlarge the urinary tract for smooth movement of stones. 
    • Stents can either be removed on the same day or during the visit to the surgeon after the surgery. 
    • May require multiple sittings for the whole procedure.

    2. ESWL (Extracorporeal Shock Wave Lithotripsy)

    • It is a non-invasive surgery that uses shock waves to break kidney stones into smaller fragments. 
    • The procedure is done under spinal anesthesia.
    • The stone debris is expelled from the body through the urine.
    • ESWL may require multiple sessions to break the stones completely.

    3. URSL (Ureteroscopic Lithotripsy)

    • The patient is administered with general or spinal anesthesia. 
    • The surgeon inserts a thin tube called a ureteroscope which is passed through the urethra and into the ureter to remove the stone.
    • The urologist uses a ureteroscope with a camera and light on the tip.
    • The urologist locates the stone and breaks it into smaller fragments. 
    • The stone debris is flushed out of the body through the urine.

    4. PCNL(Percutaneous Nephrolithotomy/Nephrolithotripsy)

    • The patient is under the effect of general anesthesia. 
    • PCNL is a minimally invasive surgery for the treatment of stone size more than 15mm.
    • The urologist locates the stones with the help of a nephroscope.
    • This surgery involves an incision of around 1cm in the flank area.
    • Nephroscope locates the stones, and the urologist removes the stones consecutively. 
    • Stones can either be removed while they are intact or are broken into fragments and vacuumed out. 

    Risks and complications of untreated kidney stones

    Prolonging kidney stones can lead to several complications around the organs and tissue surrounding the stone. Sometimes, the size of the stone is large enough to obstruct the ureteral passage. It is a serious threat to the ureter, bladder, and other parts around the renal stone. Therefore, early diagnosis is very important to determine the presence of stones and prevent them before any major complications. Delaying kidney stones surgery can cause the following complications – 

    • Increased risk of urinary cancers
    • Frequent infections in the urinary tract
    • Inflammation of the kidneys due to restricted urine flow
    • Injuries to the urinary tract
    • Permanent damage in either kidney resulting in kidney failure
    • Urinary bladder blockage that may result in painful urinary retention

    Post-surgery care and restriction after undergoing kidney stones surgery

    The patients are usually under the effect of spinal or general anesthesia. It may take time to regain consciousness completely. In the case of invasive surgery, there may be a slight discomfort around the site of the incision. Our urologists and surgeons at KidneyStonesDoctor guide the patients throughout the recovery and monitor their progress and ensure they are in the best of their health. Post-recovery tips after the kidney stones surgery include- 

    • Drink excess water every day
    • Avoid spicy food for at least two months after the surgery
    • Avoid food containing high animal proteins
    • Do not stagnate yourself entirely from any physical activities
    • Avoid too much physical activity that can put immense strain on your abdomen
    • If there are stents inside you, you must not engage in too much exercise or outdoor sports