Urine contains many dissolved minerals and salts. High levels of these minerals and salts in urine can lead to kidney stones, otherwise known as calculi stones. Diet, excess body weight, medical conditions, and certain supplements and medications are among the many causes of kidney stones.
Kidney stones are small at first but can grow and even fill hollow structures inside the kidney. Some stones remain in the kidney and do not cause problems. However, some travel down the ureters, the tubes between the kidneys and the bladder. When stones reach the bladder, they are usually expelled from the body as urine. But, when a stone becomes lodged in the ureter, it can block the flow of urine from the kidney and causes pain.
Treatment depends on the type of stone, severity, and duration of symptoms. In many cases, you can wait until the stones pass on their own. In other cases, you may require medication to relax the ureter so the stone can pass easily.
If the stone fails to pass, your next option may be surgery, especially if it affects kidney function. Kidney stones should also be removed by surgery if they cause repeated urine infections or block the flow of urine from the kidney.
Dr Louw-Waldi Vlok offers a range of treatments for managing kidney stones in the urinary tract.
Percutaneous nephrolithotomy is a standard procedure that removes kidney stones. During the procedure, Dr Vlok will create a passageway from the skin on the back to the kidney. Then, special instruments are passed through a tiny tube in your back to locate and remove stones from the kidney.
Dr Vlok performs percutaneous nephrolithotomy in the hospital under general anaesthesia. It's common to have the kidney stones sent for testing after the procedure to determine the type of stone and how to prevent them in future.
Extracorporeal shock wave lithotripsy is a procedure that breaks up stones inside the urinary tract using shock waves. These are generated by a machine called a lithotripter and target specific areas based using X-rays. As a result, the stones are broken into smaller pieces to pass through the body and exit with urine.
ESWL is the primary non-invasive treatment for kidney stones. It is suitable for people with small stones that are easy to see on X-rays.
ESWL is not recommended for people with chronic kidney infections because some fragments may not pass through, and the bacteria may not completely clear from the kidneys. It may also not work for people with blockages or scar tissue in their ureters that may prevent the passage of stone fragments.
Ureteroscopy is a procedure whereby Dr Vlok inserts a small scope into the bladder and ureter, allowing him to look into the ureter, find the stone and remove it.
For smaller stones, a tiny basket-like device is passed into the lower ureter through the bladder, that grabs the stone and pulls it free. For larger stones, or if the diameter of the ureter is narrow, the stone will need to be fragmented, which is typically done with a laser. Once the stone is broken into smaller pieces, they are removed.
It's not uncommon for the ureter to swell during ureteroscopy, so Dr Vlok may leave a ureteral stent, a small tube, inside the ureter to ensure proper urine drainage after the procedure.
Ureteroscopy can usually be performed as an outpatient procedure. However, patients may require an overnight hospital stay if the procedure proves to be lengthy or complicated.
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