What are Kidney Stones?

Kidney stones are a common and painful medical problem. Kidney stones are formed when salts in the urine precipitate and form solid material bound together by a protein matrix. Common components are Calcium, Oxalate, Megnesium, Ammonium, Phosphate and Uric Acid.

What do Kidney stones look like?

Kidney stones may be small or large and either smooth or jagged. They are usually yellow or brown.

Where are the stones present?

The stones may be in the Kidney, ureter or the urinary bladder.

What are the symptoms of kidney stones?

* Pain
* Blood in urine
* Fever and chills
* Vomiting
* Urine smells bad or looks cloudy (pus in urine)
* A burning feeling when urinating

Is it a serious disease & what are its complications?

Yes, it is a serious disease with many complications like pain, infection, kidney damage and kidney failure if timely treatment is not done.

Are kidney stones common in India?

Yes, Kidney stones are very common in India and states of Jammu and Kashmir, Himachal Pradesh, Punjab, Haryana, Rajasthan, Gujrat, Uttarkhand and some parts of Uttar Pradesh fall in the global stone belt. this can be due to climatic reason ans food habits.

What are the treatment options for kidney stones?

Stones disease management involves treatment of the existing stone and preventive measures against recurresnces. Many small stones pass out by themselves through the urinary tract with the urine, however pain can be severe and require hospital admission and pain killer medicines. Many stones require open operation or endoscopic keyhole surgery.

Now a new invention, Extracorporeal shock-wave Lithotripsy (ESWL) is available for effective treatment of kidney stones with little pain or discomfort using an intense bean of ultrasound to smash large kidney stones into small fragments and powder that can pass out in urine.

What is Extracorporeal Shock Wave Lithotripsy (ESWL)?

ESWL is an equipment to treat urinary stones with rays without surgery. During ESWL the stone is localized using an image intensifier and high frequency shock waves are focused onto the stone, which results in its mechanical disintegration into small particles. The breaking up of the stones can be seen on the imaging system. The fragmented stone passes out in the urine. Number of treatment sessions depends on the size and location of the stone. Patients with single kidney and some large stones may temporarily require Double J Stent to be placed by a cystoscope that is latter removed.

What are the advantages of Lithotripsy?

* No cut and no scars (as in surgery)
* Safe - no anaesthesia
* Age no bar - Safe even in children and elderly
* No blood transfusion or AIDS risk
* OPD walk-in walk-out treatment
* Minimum work loss
* Can be safely treated in recurrent stones
* Comfortable - Most patients need nil or minimal sedation and pain killers
* Life saving for patients unfit for surgery, single kidney patients etc.
* Economical
* Satisfactory - Patient can see stone passing out in urine and confirm its removal with check X-Ray

What test will be required before treatment?

Before treatment, blood and urine tests, X-rays KUB and IVP and ECG are done to determine the type of stone, function ofthe kidney as well as to ensure safety of the patient. Some patients may need other tests like ultrasound, Renal DPT scan, CTscan, MR!, etc.

What preparations are required before treatment?

A high liquid intake the night before the treatment and a mild laxative on the eve of procedure is recommended. Patient should come to the hospital on the morning of lithotripsy treatment empty stomach after an overnight fasting.

What will I feel during the treatment?

During the treatment, which is usually least painful, the patient can relax comfortably on the treatment table and talk to doctors and nurses. Appropriate medications will be provided in case of any discomfort.

Howlong does the treatment take?

The average treatment time is 20-40 minutes.Single small stone may take less time to clear and large or multiple stones will take longer and multiple treatment sessions .

Where all is Lithotripsy effective?

ESWL can usually remove stones from all parts of the urinary tract like - kidney,ureter and urinary bladder.

How can recurrence of kidney stones be prevented?

Kidney stones recurrence is common. This can be minimized by appropriate measures that can be advised only after studying the various tests.

Can Desi treatment help?

Many claims have been made of removal of stones with Desi medicines. For those who wish to try them we suggest to adopt it scientifically by assessment every two weeks and continue Desi medicines only if some progress is observed and there is no stress on the kidney. Single kidney patients and those at risk of kidney damage should not take the risk of trying slow treatment methods. In our opinion most stones larger that 4 to 6 mm require intervention.

Is conventional surgery still required for stones?

Only few patients may need open surgery.

Advantages and disadvantages of the various treatment methods

Comparison	Surgery	PCNL	ESWL
Procedure	Yes	Sometime	Rare
Blood	Sometime	May be	No
transfusion	Yes	Minor	No
Scar of cut	+++	++	Nil
Pain	About a week	Few days	1 hours*
Hospital stay	In Months	In weeks	Same day
Return to work	+++	++	Next Day
Procedure	Not possible	May not	Possible & safe
danger	Preferably	possible	Treatment's
Unfit patients	avoided	Preferably	choice
Recurrent	++	avoided	Negligible
Stone Complications	Rare Reluctant due	+ Very rare	Nil Very well
Procedure	to risk and	Reluctant due	accepted

* May be needed for the basic disease.

What will it cost?

The cost of Lithotripsy treatment varies depending on the nature and type of the kidney stones.