Kidney Stone Treatment
Physicians at Associated Medical Professionals are trained in a variety of treatment options for both acute kidney stone attacks which require urgent care and treatment as well as evaluation and treatment of non-obstructive and asymptomatic kidney stones as well as chemoprevention of patients who are chronic kidney stone formers.
Most patients are unaware of the presence of kidney stones until they end up in the Emergency Room with an acute attack of renal colic which typically means severe back and flank pain which may radiate into the groins as well as blood in the urine, severe nausea, vomiting, possible fever or chills and passage of stone like material. It can also lead to irritated urinary symptoms of voiding more frequently and urgently as well as loss of bladder control.
Kidney stones are typically found on radiologic imaging which most commonly includes a CT scan of the abdomen and pelvis performed urgently in the office or in the hospital setting.
The initial management can include conservative therapies including pain control, increased hydration, straining of the urine to assess for passage of the stone as well as medical expulsive therapy which includes medication to assist in passage of the stone without surgical intervention. The symptoms of kidney stones can be associated with a more serious disease like cancer that needs to be carefully evaluated by a urologist.
Treatment options for kidney stones include: observation as the majority of smaller stones will pass on their own, medical expulsive therapy which may include medications to help the stone pass more easily. Other options include in-office procedures such as removing of the stone using telescopes, shockwave lithotripsy which is typically performed under mild sedation in order to fracture the stone into smaller, more passable fragments, interventions with endoscopes which means removal of the stone either by basketing smaller stones or performing laser procedures or other modalities to fragment the stone and remove it which are typically performed in an ambulatory setting. Percutaneous methods are also used to extract stones particularly from the kidney for larger stones that are more problematic. Laparoscopic and da Vinci robotic-assisted techniques are also considered for larger and more problematic stones.
A major portion of kidney stone evaluation and treatment includes the prevention of stones following the acute episodes including possible 24 hour urine collections and evaluation of any stone material which may be passed to try to minimize any further stone production in those patients that have recurrent problems as well as in patients who are young.