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All you need to know about kidney stones.
Q. Kidney stones are a major cause of pain and distress to the patients suffering from them. Q1. Are kidney stones common in India?
A. 1 in 10 individuals develop kidney stones in our country. Kidney stones are a very common cause of problem in India and especially Gujarat because of the dry and hot weather.
Q. What are the symptoms of kidney stones?
A.
- Pain
- Infection
- Nausea and vomiting
- Asymptomatic
- Kidney failure
Often patients have pain in flank ie. The side of the back, in the lower abdomen or towards the genitals.
Sometimes there can be nausea, vomiting with the pain. This may be indicative of stone in the ureter, which is the pipe connecting the kidney to the bladder.
Infections can also be a presenting symptom of kidney or ureteric stones.
Unfortunately some kidney stones can go unnoticed because of a lack of pain. These can increase in size over time and lead to kidney failure. It is still a harsh reality in our country that patients end up with kidney failure due to stone disease.
There are also however some stones that are incidentally detected on sonography done for unrelated reasons.
Q. How are kidney stones diagnosed?
A. Kidney stones are diagnosed often by sonography also known as USG or Ultrasound.
However the most accurate way of diagnosing stone disease and of planning stone surgery is to do a CT scan with assistance from the best doctor for kidney stone in Ahmedabad. A CT scan is like a three dimensional X- ray and is done in a rotating circular tube with the patient lying down.
Plain X rays are rarely used in diagnosis but often in follow up.
Q. Do all stones need surgery?
A. Definitely not.
Decision for treatment of stone disease is individualised and our best doctor for kidney stone in Ahmedabad at Shyam urosurgical hospital take an individualised approach to stone treatment keeping the patients opinion and well being at the forefront. The call based on many factors.
The main determining factors are:
- Symptoms of the patient
- Size of stone
- Location of stone
- Obstruction to kidney
- Patients physical condition
Based on these factors the decision to treat stones can be taken.
Many stones that are not symptomatic, lying in the corner of a kidney, with no infection can safely be observed.
Very small stones that are usually <7mm that are stuck in the urine pipe that is the ureter can be treated with medication and must be followed up to see their passage.
Larger stones need surgical treatment.
Q. What are the surgical modalities available for treatment of stone?
A. There are 3 main surgical methods for stone surgery in the modern era.
- RIRS also known as flexible ureteroscopy and removing stone by using urinary passage via the urinary opening.
- PCNL ie making a tiny hole in the kidney from the side and removing stone.
- ESWL ie. Shockwave lithotripsy.
Q. Which surgical modality is used in which condition?
A. For stones that are soft and less than 1 cm and in the upper or middle part of the kidney, one can use ESWL or shockwave lithotripsy.
For harder stones up to 2.5 cm in size one can perform RIRS.
For larger stones in the kidney PCNL has to be used.
For stones in the ureter Ureteroscopy also called URS is used.
We have animated videos of all the surgeries in our video gallery for viewing.
Q. Shyam Urosurgical hospital is a pioneer in cutless stone surgery. What is it?
A. Cutless stone surgery is a common term for RIRS. In this a delicate endoscope passes from the urinary passage and goes up to the kidney.
We were among the early adopters of this technology in not just Ahmedabad or Gujarat but across India.
We use the latest and best quality LASER available in the world along with the best and newest endoscopes. This enables us to give patients quality care.
LASER is an energy which is used to break stone. We used the Thulium fiber Laser and the Holmium laser for our surgery.
Q. Is this surgery free of complications?
A. No surgery is free of complications or 100% successful. However RIRS is relatively free of complications. The concerning complication is infection which can be managed with medications and observation.
We have a protocol that has enabled us to decrease our complication rate to below even international standards.
Q. What protocols do you follow for decreasing infections?
A. We send the urine for examination to make sure there is no infection. If there is infection we treat it with antibiotics before proceeding.
We also use plasma sterilization for all our equipment. This is an expensive machine which is available at only a handful of centres in Ahmedabad or Gujarat.
We do not compromise on the safety standards.
Q. Is there robotic surgery for stone disease?
A. It is currently in research and development. Convention robotic abdominal surgery is required in rare circumstances only.
Q. Why do some people form stones?
A. Like some people get high blood sugar, diabetes, it has been seen that people with some genes have higher tendency to form stone.
Factors like low water intake, hot dry weather, working in heat can all contribute to stone formation.
In some people eating specific types of food also can lead to stone formation.
Q. Do Kidney stones happen again once treated?
A. Unfortunately these stones can form over and over again. They tend to recur in about 50-60% of patients.
Q. How can we prevent formation of stone again?
A. Tests about the type of stone, blood and urine tests to identify the reason for stone formation can guide us on long term use of some medicines, and appropriate dietary modifications. This will enable us to decrease chances of stone formation.
However these medicines often have to be taken for a long period of time. And inspite of the best of dietary control and medication stones can still form in those with a strong tendency for stone formation. In order to prevent stones from forming again at Shyam urosurgical hospital we run a stone prevention clinic to best guide our patients.
One important thing to prevent future stone formation is to make sure stone is completely cleared during surgery.