Minimally Invasive Procedures for Kidney Cancer & Prostate Cancer

Stones
Ureteral, Bladder, and Kidney Stones
Ureteral, Bladder, and Kidney Stones

Ureteral, Bladder, and Kidney Stones

Important: This article is not intended to replace a physician examination, review of your pathology report and consultation.

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Kidney Stone Statistics

 

  • Kidney stones are a major cause of morbidity.

  • The lifetime prevalence of symptomatic nephrolithiasis* is approximately 10% in men and 5% in women.

  • More than $2 billion is spent on treatment for kidney stones each year.

What Are Kidney Stones Composed of?

  • About 80% of kidney stones contain calcium, and the majority of calcium stones consist primarily of calcium oxalate.

How Does Body Size Relate to Kidney Stone Formation?

  • Urinary pH has been found to be inversely related to body weight: the higher your bodyweight, the lower your urinary pH.

  • Larger body size may also result in increased urinary excretion of uric acid and oxalate, risk factors for calcium oxalate kidney stones.

  • However, body size does not only refer to fat mass as it is possible that even lean body mass is at least partly responsible for the observed association between higher BMI and increased risk for kidney stones.

  • The strong association between weight gain since early adulthood and the risk of incident stone formation suggests that adiposity (fat mass) plays a central role in the relation between body size and nephrolithiasis.

BMI and Kidney Stones

  • BMI is not an indication of body fat percentage.

  • Women generally have a higher percent body fat than men.

  • A woman with a given BMI will, on average, have more adipose tissue than a man with the same BMI.

  • However, higher lean body mass may account for the greater incidence of kidney stone formation in men compared with women.

Hyperinsulinemia and Insulin Resistance

  • Obesity is associated with insulin resistance and compensatory hyperinsulinemia**, metabolic derangements that may lead to the formation of calcium-containing kidney stones.

  • Hyperinsulinemia is associated with obesity and has a significant effect on urine composition.

  • Hyperinsulinemia contributes to the development of calcium stones by increasing the urinary excretion of calcium.

  • Insulin resistance, also associated with obesity, may manifest in the kidney as a defect in ammonium production and the ability to excrete acid.

Uric Acid and Obesity

  • There is a positive association between BMI and the urinary excretion of uric acid.

  • Urinary uric acid is a risk factor for calcium oxalate stones and is also positively associated with obesity.

  • Data from nearly 6,000 individuals with a history of kidney stones suggests that urinary uric acid excretion is higher in heavier patients.

The Bottom Line

  • Obesity and weight gain are associated with an increased risk of symptomatic nephrolithiasis.

  • The positive association between body size and the risk of kidney stone formation could not be explained by differences in the intake of dietary factors that affect risk.

 

*Nephrolithiasis – The process of forming a kidney stone.

**Hyperinsulinemia - A condition in which there are excess levels of circulating insulin in the blood, often associated with Type 2 diabetes.

Taylor, E N et al. Obesity, Weight Gain, and the Risk of Kidney Stones. JAMA, 2005 – Vol 293 No. 4 p455-462.

You can prevent kidney stones by avoiding salts, and foods and drinks containing phosphoric acid (especially brown sodas). Also, consider drinking 2-4 glasses of water at night after your meal with a tablespoon of lemon juice per quart of water. Orange juice, diluted with water, in the mornings can just as easily help.

What is ESWL?

Extracorporeal shock wave lithotripsy (ESWL) is a safe effective method of removing kidney stones without an incision. ESWL generates pressure waves created outside the body to crush stones inside the kidney. With this procedure, there is less risk to the patient and less pain.

What Happens During the Procedure?

During ESWL the sedated or anesthetized patient is positioned over a shock wave conducting cushion. X-rays pinpoint the exact location of the stone(s). Then after targeting, an electrode creates shock waves which pass through the water cushion and body to pulverize the stone(s) while not harming the tissues. After EWSL, the patient will wake up in the recovery room and then will be sent to a holding room until able to take fluids well.

Following the procedure, the "crushed" stone fragments pass naturally in the urine. In most instances stone particles pass with little or no pain, reducing costs and the need for prolonged hospitalization. Patients are advised to drink extra water to help pass any remaining 'sand' that might exist in the organ. Patients can return to work and all other activities in a few days.

Am I a Candidate for ESWL?

Our physician, Dr. Mark Thomas, will examine you to diagnose a plan for proper care. Your personal examination, x-rays, and medical history will be taken into account. Some patients need additional tests to determine the severity of the condition. This may include sampling your blood, urine, bacteriological tests, EKG and the isotope studies of renal function. Most kidney stone sufferers are candidates for ESWL. Depending on your weight, functionality of kidneys, etc, another form of treatment may be recommended.

How Is The Stone Found?

During ESWL, Dr. Mark Thomas will use the lithotripter's elaborate hydraulic and flouroscopy system to accurately locate and position your body relative to the stones. Dr. Thomas further monitors the stone's position during the procedure, including the rate of fragmentation and the amount of power needed for your treatment.

What Happens Once I'm Done?

Some stones require more than one treatment as well as an internal drain to prevent pain while passing the 'sand'. To help eliminate the 'sand', you will be encouraged to drink up to 12 8-ounce glasses of water a day. You are also encouraged to walk as soon as possible. Activity and fluids help the passage of fragments. Do not be alarmed if you see blood in your urine for a few days after the procedure or until the drain is removed. Medication will be prescribed for pain and nausea as needed. Further instructions will be provided and you can expect to resume normal activities within 2 to 5 days. One month later, an x-ray will be taken to confirm the stone's passage. It may be analyzed to prevent formation of another stone. Three months after surgery, you should have had time to change some dietary habits. Metabolic tests can begin to prevent further pain.

Map to El Paso Urology

El Paso Urology
4687 N Mesa, Suite 100
El Paso, TX 79912
Ph. (915) 532 3119
Fax. (915) 351 6048

Business Schedule

Monday 9:00AM - 5:00PM
Tuesday 9:00AM - 5:00PM
Wednesday 9:00AM - 5:00PM
Thursday 9:00AM - 5:00PM
Friday* 9:00AM - 2:00PM

*Friday by appointment only*