Treatment for Kidney Stones

When kidney stones strike, there is no mistaking the pain and discomfort associated with them when they pass. Kidney stones are comprised of salts and minerals in the urine that bind together, forming small crystals that build up inside of the kidney. Kidney stones may be as small as a grain of sand or as large as a golf ball. They are usually painless while in the kidney but can cause severe pain if small pieces of these crystals break off and travel through the narrow tubes (ureters) to the bladder.  Some stones pass out of the body without the need for intervention, but others can get trapped in one of the ureters, causing major pain and may even require surgical intervention.

As a foremost specialist in the treatment of urological conditions such as kidney stones, Dr. Lerner urges anyone with the following symptoms to call their physician immediately:

Symptoms:

  • Sudden intense pain in your back or side near your kidney, which may radiate toward your abdomen, groin or genitals
  • Nausea and/or vomiting
  • Blood in your urine
  • Frequent and painful urination
  • Fever, especially if accompanied by other symptoms (may be an emergency if a stone is blocking the ureter)
  • Some stones, if they are small enough, cause no symptoms at all.

Risk Factors:

  • Caucasian males, ages 20 - 60 years
  • Dehydration
  • A diet too high in salt, calcium or oxalates (such as spinach, chocolate, nuts), excess vitamin C or D or a high protein diet
  • Family history of kidney stones or a previous stone
  • Metabolic diseases (such as hyperparathyroidism or gout)
  • Inactive lifestyle or prolonged bed rest
  • Frequent urinary tract infections or other bladder problems
  • Inflammatory bowel disease (IBD) such as Crohn's disease
  • Certain rare hereditary disorders

Diagnosis

To accurately diagnose kidney stones, Dr. Lerner will take a detailed medical history and perform a thorough physical exam. He may also order one of the following tests to determine if and where a stone exists:

  • Plain X-ray ("KUB" of the kidneys, ureters and bladder)
  • CT scan 
  • Ultrasound

Treatment Options

Many kidney stones do not require treatment or will pass without surgery. However, if your kidney stone is large or will not pass on its own, Dr. Lerner can perform one of several procedures to alleviate your pain and eliminate the stone:

  • Extracorporeal Shock Wave Lithotripsy (ESWL) - shock waves pass through the body and break up the kidney stone into smaller, more easily passable fragments.
  • Ureteroscopy with Lithotripsy - a special videoscope is passed into the urinary tract, where the stone can be grasped or broken into smaller pieces with a laser.
  • Percutaneous Nephrolithotomy - a videoscope is placed directly into the kidney from the back to break up and remove large or complicated stones.


In the majority of kidney stone patients, one of the above treatments performed by Dr. Lerner will prove successful in eliminating the kidney stone. In a small percentage of patients, major surgery (nephrolithotomy) may be necessary when other methods are not successful.

Reducing Your Risk of Kidney Stone Recurrence

Because recurrent or additional kidney stones will develop in more than half of those individuals who have already develop one kidney stone, Dr. Lerner will often order special urine and blood tests to help determine how to decrease the risk of recurrence. Based upon these results, Dr. Lerner may suggest you:

  • Drink more water
  • Reduce salt and/or protein intake
  • Avoid foods high in oxalate
  • Avoid/reduce caffeine
  • Eat a special diet
  • Take special medications or antibiotics
  • Watch your calcium intake


Additionally, Dr. Lerner may refer you to a nutritionist for specific dietary guidelines.

When it comes to providing the very best care for his patients, Dr. Lerner leaves no stone left unturned. His ultimate goal is your future good health.