Understanding Kidney Stones: From Symptoms to Treatment
Introduction
More than 10% of the population in Singapore will develop kidney stones with a 30 to 50% recurrence rate in their lifetime. This condition is more prevalent in men than women and affects individuals at any age.
Kidney stones symptoms differ depending on the location. It may block the ureters, causing a backflow of urine, kidney swelling, and intense spasms. If untreated, kidney stones increase the risk of urinary and kidney infections.
Causes of Kidney Stones
Kidney stones form due to low water intake and a high chemical concentration. When crystal-forming substances, such as calcium, oxalate, and uric acid, are higher than the urine fluid, these crystals can bind and form kidney stones.
Risk factors contributing to kidney stone formation
- Males
- Old age
- Family history
- High sodium and protein diet
- Gout
- Hypercalciuria and Hypocitraturia
Symptoms of Kidney Stones
The early symptoms of kidney stones may start as the stones grow and travel down the kidney. Depending on the location, signs and symptoms of having kidney stones include
Other kidney stone symptoms in men may include lower back and groin pain when the stone passes through the ureter. In contrast, symptoms of kidney stones in females may compare to menstrual cramps, escalating from dull aches to wincing pain.
Other kidney stones symptoms
Diagnostic Tests for Kidney Stones
A diagnosis of kidney stones in Singapore start with a thorough physical examination and an understanding of medical history and symptoms.
To identify primary causes, confirm the diagnosis, and aid in planning specific and appropriate treatment, your urologist may use the following tests:
- Urinalysis examines urine’s physical and chemical composition, such as pH and the presence of microhematuria and crystals.
- Urine culture inspects for urine bacteria to rule out urinary tract infections.
- Abdominal and Kidney Ultrasonography uses high-frequency sound waves to produce images of internal organs. It detects stones stuck in the kidneys.
- X-ray (plain radiography) commonly detects the location and size of calcium stones.
- Intravenous pyelography requires contrast material to view kidneys, ureters, and bladder and locate stones.
- CT (Computerised Tomography) Scan identifies all types of kidney stones in all locations and rules out other non-urologic abdominal pain.
Treatment for Kidney Stones
Surgery and other medical interventions to treat kidney stones depends on the stone’s size and location. If the urologist rules out sepsis or infection as a complication, conservative management focusing on pain relief is more suitable for the patient. However, for stones larger than 6 mm that fails to pass naturally within 2-4 weeks, the following kidney stones treatment techniques are recommended.
1. Medical Expulsive Therapy uses alpha-adrenergic receptor antagonists and calcium channel blockers to dilate the distal ureter, allowing stones to pass.
2. Oral Dissolution Therapy is a kidney stone treatment that uses oral agents to modulate urine pH to 7, increasing urinary volume and dissolving kidney stones.
3. Shockwave Lithotripsy involves high-energy shock waves to break the stones, allowing them to pass. This is a non-invasive procedure under sedation, making the treatment painless.
4. Ureteroscopy uses an endoscope to access and deliver targeted laser energy to dissolve kidney stones. This procedure removes renal and ureteral stones when medical expulsive therapy fails.
5. Percutaneous Nephrolithotomy is a kidney stone surgery that removes larger than 2 cm stones. This procedure requires a 1 cm incision at the back to insert the endoscope directly into the kidney.
Consult a urologist for an accurate diagnosis and a suitable personalised and specific treatment plan to prevent complications from kidney stones.
Recovery
Recovery from kidney stones treatment in Singapore depends on the size and location of the stones, the individual’s overall health, and the treatment received. For example, older individuals may have a more challenging time recovering due to weakened immune systems. Patients must take careful aftercare management during this time to ensure proper healing.
Recovery tips after surgery for kidney stones
- Drink plenty of fluids
- Avoid straining to have a bowel movement
- No strenuous exercise and driving
- Take pain medication as prescribed
- Follow up with your urologist
Prevention of future kidney stones is also critical to ensure long-term recovery. Increasing dietary calcium intake, reducing sodium intake, and avoiding foods high in oxalate prevents the formation of new stones.
Conclusion
Kidney stones affect both men and women. However, men are more likely to develop and experience more severe symptoms due to higher sodium and protein intake. Common kidney stone symptoms in males include severe pain in the lower back or side, blood in the urine, and difficulty urinating.
For proper symptom management, kidney stone removal in Singapore may depend on the size and location of the stones, the individual’s overall health, and lifestyle. This includes shock wave lithotripsy, ureteroscopy, and percutaneous nephrolithotomy.
In addition to medical treatment, self-care tips such as staying hydrated and avoiding foods high in oxalate prevent the recurrence of kidney stones in men and women.
If you are experiencing kidney stone symptoms, consult a urologist for early diagnosis, individualised symptom management and treatment, and better recovery before complications develop.
Take proactive steps and seek kidney stone treatment early today.
