Do you suffer from painful kidney stones?

Q: Why are my kidney stones so painful, and what are my options to get rid of them?

A: Kidney stones form when your urine contains more crystal-forming minerals and salts than the fluid in your urine can dilute, with about 85 percent of kidney stones being calcium-based. A stone causes pain when it blocks urine from leaving the kidney through the ureter, a pipe that drains the urine from the kidney to the bladder.

Kidney stones are known for causing the following symptoms:

• Pain spasms
• Nausea and vomiting
• Blood in the urine
• Urinary frequency and urgency

When the pain is severe, narcotics may be prescribed; otherwise, over-the-counter pain medications may be used.

The treatment of kidney stones depends on many factors including: size, type and location. The type of stone a patient is suffering from can be determined by blood and urine tests. When a stone passes or is removed, it can also be sent for chemical analysis.

Three common options are:

• Time. When stones are small and the pain is manageable, a patient can be given time to try to pass the stone on their own. Usually, a medication to relax the muscles in the ureter is prescribed to aid in passage of the stone.
• Medications. Less common stones which are not calcium-based can sometimes be dissolved with medications.
• Surgery. If the patient fails to pass the stone in a reasonable time frame or has worsening pain despite pain medications, a procedure is required. Two primary types of surgical intervention can be offered: extracorporeal shockwave lithotripsy (utilizing external sound waves to break up the stone) or ureteroscopy and laser lithotripsy (utilizing a telescope and laser to break up the stone). Often, a temporary ureteral stent or plastic tube is placed to allow urine to drain around stone fragments and allow the ureter to dilate.

How to Avoid Kidney Stones in the First Place
I tell all of my patients that the number one way of preventing kidney stones is to drink plenty of water. If you have a history of kidney stones, I recommend that you talk to your primary doctor about prevention strategies to avoid future stones. Additional tests may be required to figure out if dietary changes or medications are required.

Dr. Aaron Ovadia is a urologic surgeon who offers a wide spectrum of urologic procedures including new innovative outpatient endoscopic treatments and robotic surgeries. He has interest in general urology with focus on BPH, nephrolithiasis, and robotic surgery.