Kidney and Ureteral Stones

Stone disease, also called urolithiasis, is a common and painful urologic disorder affecting 13 percent of males and 7 percent of females by age 70 in the United States. Kidney stones form in the kidney. Ureteral stones are kidney stones that move into the ureter. Stones form when there is an imbalance between chemical substances in the urine such as calcium, oxalate and phosphate. A less common type of stone, a struvite or infection stone, is caused by a urinary tract infection. Rarer stones include pure uric acid stones and hereditary stones called cystine stones.

Most kidney stones and ureteral stones pass out of the body without intervention. But sometimes, medical help is needed. Urologic surgeons at Brigham and Women’s Hospital (BWH) offer the newest treatment methods to treat stone disease including a mobile lithotripsy unit, an incision-free technology which uses shock waves to dissolve kidney stones and ureteral stones.

Kidney Stones Topics

Risk Factors for Kidney Stones

While there is not one definitive reason for the development of kidney stones, many factors contribute to the condition. Risk factors include:

  • Caucasian male
  • Family history of kidney stones
  • History of urinary infections or diseases
  • Dehydration
  • High-protein diet
  • Intake of oxalate-rich foods
  • Certain bowel conditions
  • Obesity
  • Urinary obstructions
  • Endocrine disorders
  • Calcium disorders
Symptoms of Kidney Stones

The following are the most common symptoms of kidney stones.

  • Sharp, cramping pain in the back, side or lower abdomen
  • Pain can come and go
  • Blood in the urine
  • Nausea and vomiting
  • Cloudy or odorous urine
  • Frequent urination
  • A burning feeling when you urinate
  • Fever and chills
  • Prompt medical attention for kidney stones is necessary.
Diagnosis of Kidney Stones

In addition to a complete medical history and physical examination, diagnostic procedures for kidney stones may include the following:

  • Intravenous pyelogram (IVP), X-rays of the kidney, ureters and bladder with  contrast dye injection into a vein to detect abnormalities and assess renal blood flow.
  • CT-scan, an imaging study of the kidney, ureters and bladder with contrast dye to find abnormalities or obstructions, and to assess renal blood flow.
  • Urinalysis, a laboratory examination of urine for red and white blood cells, infection or excessive protein.
  • Blood tests to detect substances that might promote stone formation.
  • Renal ultrasound, a picture of the kidney to determine its size and shape and to detect abnormalities or obstruction.
Treatment for Kidney Stones

Stone size, the number of stones and their location are important factors in deciding the appropriate treatment for kidney stones. Surgical treatment of stones may include:

  • Shock waves or extracorporeal shock wave lithotripsy (ESWL) sends shock waves to the kidney stone to break a large stone into smaller stones that will pass through the urinary system.
  • Ureteroscope inserts a long wire with a camera into the urethra and through the bladder to the ureter where the stone is located and removed.
  • Tunnel surgery (percutaneous nephrolithotomy) makes a small cut in the back and tunnels through the skin to the kidney where the stone is removed.
Prevention of Kidney Stones

According to the National Institute of Diabetes and Kidney Disease (NIDKD), the best way to prevent kidney stones includes the following:

  • Drink more water. Up to 12 full glasses of water a day can help flush away substances that form stones.
  • Limit caffeine.
  • Consult your doctor regarding dietary modifications.
  • Medications may prevent calcium and uric acid stones from forming.
What You Should Expect

You will receive a thorough diagnostic evaluation and receive clinically-proven treatment by a board-certified urologist who specializes in treating kidney stones. Recovery times vary depending upon surgical treatment, with less invasive procedures having shorter recovery times. You will be encouraged to drink extra fluid post-operatively and may need follow-up blood and urine tests.

Multidisciplinary Care

Brigham and Women’s Hospital practices a multidisciplinary approach to patient care, routinely collaborating with colleagues in other medical specialties. If your urologist discovers that an underlying illness has contributed to the kidney stones, you will be referred to an appropriate BWH physician for an evaluation.

Resources

Go to our online health library to learn more about urology diseases and tests.

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families to access computers and knowledgeable staff.

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