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Kidney Stones

Kidney Stones are actually minerals built up in the bladder that have coalesced into small "stones."

What are Kidney Stones?

Kidney stones are more common among older men, but reports of women contracting this condition is increasing nowadays. Having this condition can be a painful and uncomfortable ordeal. Thankfully, there are several treatment options that are readily available.

Here at our kidney clinic, we specialise in the diagnosis and treatment of kidney stones; on top of a wide range of treatment services for disorders and diseases concerning the urological system.

Singapore Urologist, Dr Michael Wong was invited faculty at the USA national congress 2018. He is seen here with Prof James Lingeman whom he did a fellowship in Endourology in 1994.

What are the Signs & Symptoms of Kidney Stones?

Kidney stones vary in size. Some are so small that they do not cause any symptoms and can be passed naturally out of the body through the urine. Others are larger and may cause a blockage in the ureter, interrupting the normal flow of urine. In such cases, the following symptoms may be experienced:

  • Pain and discomfort or burning sensation while urinating
  • Pain in the sides, back, lower abdomen and groin
  • Urinating more frequently than usual
  • Dark-coloured or abnormally cloudy urine
  • Foul-smelling urine

Seek immediate medical attention if the following symptoms are present:

  • Debilitating pain that is felt even while resting
  • Inability to urinate
  • Blood in the urine
  • Nausea and vomiting
  • Fever

Severe pain can occur if large kidney stones block the movement of urine. If you encounter any of these symptoms, seek prompt medical help at a kidney stones clinic.

What Causes Kidney Stones?

If you are experiencing most of the symptoms listed above, then you most likely have kidney stones. However, what could have caused it?

Also known as Renal Calculus, this condition usually occurs when normal chemicals in urine that typically prevent this condition, have stopped working. Moreover, your diet plays a large part in the situation – what you eat and drink may actually cause the formation of stones in your bladder and kidneys.

Some food that can cause this condition include:

  • Food high in oxalate such as beets, okra, chocolate, sweet potatoes, peanuts, soybean crackers, rhubarb, and spinach
  • High intake of calcium-rich foods such as milk, cheese, yogurt, and other dairy products

Nevertheless, this condition is more often caused by other underlying health problems, such as an enlarged prostate. Here are some health problems that are known to cause kidney stones:

  • Metabolic disorders such as hyperparathyroidism, hyperuricosuria, Cystinuria and hyperoxaluria
  • Kidney disorders such as cystic kidney diseases
  • Hereditary disease such as renal tubular acidosis – this is a condition wherein the kidneys fail to acidify the urine.
  • Inflammation of the bladder or Urinary tract infection – this can increase the chances of stones forming within the urinary tract
  • Prostate gland enlargement – If a man’s prostate is enlarged, it can disrupt the normal flow of urine within the urinary tract
  • Damaged Neurogenic bladder – this may hinder the normal flow and release of urine from the bladder

What are The Different Types of Kidney Stones

There are different types of kidney stones, depending on their composition:

  • Calcium oxalate – It is the most common type of kidney stone that develops when calcium mixes with high-level oxalate (natural chemical found in foods) in the urine. This is formed due to insufficient calcium and fluid intake.
  • Uric acid – This is developed from food with high levels of protein (meat and shellfish) that produce chemical compounds known as purines in the body, which create monosodium urate. This type of kidney stone may form in people who have diabetes and metabolic syndrome, as well as those with genetic factors that put them at higher risk for this condition.
  • Struvite – This is a less common type of kidney stone caused by bacteria from urinary tract infection (UTI), which grows and expands quickly and affects the urinary tract, sometimes with few symptoms and no warnings.
  • Cystine – It is a rare type of kidney stone that is developed from families with a hereditary disease called cystinuria, which causes a chemical called cystine to leak in the urine.

How Are Kidney Stones Diagnosed?

At the onset of symptoms, a kidney stones doctor should be consulted to ensure prompt diagnosis and treatment. Aside from checking the patient’s medical and family history, the doctor may order tests, which include:

  • Blood testing – This determines if your kidneys are working properly and if there are high-levels of calcium or uric acid in your blood, resulting in kidney stones.
  • Urine Testing – This test requires collecting urine samples at the kidney stones treatment clinic for 24 hours to show whether your urine is infected and contains blood or minerals that can form kidney stones.
  • Image Testing – An X-ray, CT scan or MRI are conducted to determine the location, size and number of kidney stones present. The result can help decide the most suitable kidney stones treatment, which may range from medication to kidney stones surgery.

How to Prevent Kidney Stones Formation?

Drinking enough fluids is a primary preventive method. Doctors recommend drinking enough fluids to pass about 2.5 liters of urine a day. Doing so can help urine to be less concentrated and reduce the risks of kidney stones formation.

It’s also good to reduce the amount of salt in your diet as this can lead to high levels of urine calcium and cystine. High-sodium food, including cheese, processed meats, frozen and canned food, and certain condiments should also be avoided.

Another preventive measure is having calcium-rich foods such as non-dairy milks and products in your diet plan as these do not contribute to the formation of kidney stones. On the other hand, calcium supplements do increase your risk of kidney stones, and so intake should be carefully regulated.

Eating fruits and vegetables rich in potassium and fiber can help reduce the formation of kidney stones. You should also manage eating foods with high levels of oxalate like chocolates, spinach, black pepper and soy products.

Maintaining a healthy weight can be a preventive factor, but seek advice from your healthcare provider for a proper diet plan as high-protein and crash diets can cause kidney stones.

What are the Available Treatments for Kidney Stones?

Kidney stones treatment will depend on the type of stone and the severity of the symptoms.

If you have detected them early while they are still small, you can simply drink more water, more regularly. This is usually enough to get rid of them naturally.

However, if the stones are already too large to pass naturally, its treatment will then involve breaking them down into smaller pieces or removing them via kidney stones surgery by your kidney specialist. Here are several treatments employed to remove them:

  • Extracorporeal Shock Wave Lithotripsy - Extracorporeal Shock Wave Lithotripsy (ESWL) is a procedure that uses shock waves in the treatment of kidney stones in the bladder. These shock waves break down stones into small pieces.
  • Retrograde Intrarenal Surgery - Retrograde Internal Surgery (RIRS) is a kidney stones surgery procedure done through a fibre-optic endoscope. The fibre-optic endoscope can pinpoint the location of kidney stones.
  • Percutaneous Nephrolithotomy - Percutaneous Nephrolithotomy (PCNL) is a procedure known as stone extraction. PCNL is a treatment technique for larger stones.
  • Laparoscopy - Laparoscopy is a non-invasive surgical procedure that uses small incisions to treat the condition.
  • Laser Lithotripsy - Laser Lithotripsy is a procedure done mostly in the lower ureteral stones using a ureteroscope. The ureteroscope breaks the stones into tiny pieces. These will eventually exit the body.

The treatment of kidney stones is one of the services offered by our kidney clinic. We also offer other specialised urology services and treatments including ESWL, retrograde intrarenal surgery, and laparoscopy.

If you suspect that you are suffering from this condition and it is affecting your day-to-day activities, do give us a call or set an appointment with kidney stones doctor, Dr Michael Wong at +65 6838 1212 today.

What are the First Signs of Passing a Kidney Stone?

Smaller stones may be asymptomatic and naturally pass from the body through the urine without any discomfort. Large stones, on the other hand, can cause a blockage in the ureter, resulting in severe pain.

Some common symptoms of kidney stones are:

  • Sharp pain in the lower back and lower abdomen
  • Blood in the urine
  • Frequent urination
  • Difficulty in voiding
  • Painful urination
  • Nausea or vomiting
  • Fever, chills or sweating

What Is the Best Way to Relieve Kidney Stone Pain?

In some suitable cases, kidney stones doctors may prescribe pain medication and alpha-blockers for faster passage of stones. In cases of severe pain or obstruction, your doctor may perform certain procedures to either break down the stone into smaller parts to be passed out from the body, or to extract larger stones.

An example of a kidney stones surgery is a ureteroscopy, which involves passing a small telescope through the bladder and ureter to locate and remove the stones.

How Long Do Kidney Stones Pain Last?

Waves of severe pain (renal colic) tend to last for 20 to 60 minutes, initially affecting the flank or lower abdomen before moving to the groin area. While the intensity of pain may change over time, it is unlikely to disappear unless properly assessed and treated by a specialist at a kidney stones clinic.

Will the Stones Go Away Without Any Kidney Stones Treatment?

Most kidney stones will actually pass on their own without treatment. However, in cases of larger stones, the pain may prove too much to tolerate without seeking prompt medical attention. You may need to consult a kidney stones treatment clinic, especially if the stones do not pass and cause a urinary obstruction. A kidney stones urologist may perform certain procedures to break apart or remove the stones.

Stone Issue

kidney stones

Kidney stones are hard, crystallized deposits that form in the urinary system. Some stones are very small and passed naturally from the body through urine. Other stones are larger, causing severe pain and obstructing urine flow. Dislodged kidney stones can also damage the inner lining of the urinary tract, resulting in blood in urine. In more severe cases, kidney stones can cause urinary infections, and kidney damage or failure.

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Dr Michael Wong

Medical Director & Senior Consultant Urologist
FAMS (Urology), FICS (USA), FRCS (Edinburgh),
M Med (Surgery), MBBS (S’pore)

Dr Michael Wong is a Senior Consultant Urologist who is internationally recognized for his surgical expertise and academic contribution to the field of Urology, in particular the subspecialized field of minimally invasive Endourology.

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