Kidney stone treatment and prevention in Snellville and Gwinnett County

What stones can feel like

• Pain in the side and back, below the ribs, that may travel toward the groin
• Pain that comes in waves and changes in intensity
• A recurring dull ache in the flank
• Pain or spasm when urinating
• Pink, red or brown urine
• Cloudy or foul-smelling urine
• Nausea and vomiting
• A constant need to urinate, often in small amounts
• Fever and chills if an infection is present

Symptoms vary a lot with the size, shape and position of the stone, and some stones cause no pain at all. A flank ache is typical of a stone, but your doctor will check that nothing else is going on in the kidney.

Why stones form

Common contributors are too little fluid, a diet high in protein or sodium, low citrate in the urine (sometimes inherited), conditions such as metabolic syndrome, obesity, diabetes and gout, overactive parathyroid glands (hyperparathyroidism), and bowel conditions or surgery, including gastric bypass and Crohn’s disease. Many people have stones without ever being evaluated for the reason they form. Advanced Urology looks for the root cause because people who have had one stone often get another.

Finding and understanding the stone

An evaluation combines your history, an exam and urine testing, usually with imaging to see the size and position of the stone and whether urine flow is blocked. Those facts decide whether waiting is safe or treatment is needed. If you pass a stone, save it for lab analysis if you can: the type guides prevention.

Treatment: from waiting to procedures

Treatment depends on stone size, position and type. Small stones may pass on their own with pain control and monitoring, if you are able to drink, have no fever and urine is flowing. Larger stones, or stones that block urine or cause severe pain, need treatment.

Shock wave lithotripsy (ESWL)

Focused shock waves from outside the body break a stone into small pieces that then pass in the urine. Whether it suits you depends on the stone’s composition, size and location. Before: tell the team about blood thinners and other medicines; any change must follow the plan from your prescribing and surgical doctors, never your own decision. During: anesthesia is usually used and the procedure is non-invasive. After: drink plenty of fluids. Mild side pain and blood in the urine are common for a few days, and most people go home the same day. Fragments can still cause pain as they pass, and a stone sometimes needs more than one treatment or a different procedure.

Ureteroscopy with laser lithotripsy

Done under general anesthesia with no cuts. A thin scope is passed through the urethra and bladder up into the ureter or kidney, and the stone is seen, broken with a laser and removed. A temporary stent is placed to help the kidney drain, and patients typically go home the same day and return in about a week to have the stent removed. Stents can cause discomfort and urgency, and a stone sometimes needs further treatment. Ask what to expect while a stent is in place.

Percutaneous nephrolithotomy (PCNL)

For very large stones, over about 2.5 cm, or stones that fill the kidney, a small opening in the back lets a scope reach the stone, which is broken up and removed. This is a hospital procedure with a stay of at least a night.

Which of these procedures is recommended depends on your stone. Ask Dr. Patel which approach is right for you and where it would be done.

Recurrent kidney stones: reducing the chance of another one

Prevention starts with knowing why a stone formed. Testing the stone, and sometimes a 24-hour urine collection that measures urine volume and mineral levels, guides personal advice.

• Fluids: for most stone types, drinking enough to keep urine pale and dilute is the most important step. Many people aim for six to eight 8-ounce glasses a day, more in hot weather or with heavy sweating, unless a doctor has told you to limit fluids for a heart or kidney condition. Citrus drinks such as lemonade may help because citrate discourages crystals.
• Diet: the right changes depend on stone type. Cutting back on sodium and excess animal protein often helps, but a blanket “stone diet” can be wrong for you, so ask before cutting foods such as dairy.
• Medicines: depending on stone type, options include potassium citrate and other medicines, or antibiotics for infection-related stones. They can have side effects and are taken for set periods.

Common questions