How Does Dr. Amar Raval Diagnose & Treat Kidney Stones?

KEY TAKEAWAYS:

  • Kidney stones are prevalent in Florida, with dehydration and heat as contributing factors.
  • Dr. Amar Raval, a urologist in Tampa, FL, employs imaging tests to diagnose kidney stones and determine the most appropriate treatment.
  • Treatment options for kidney stones include stent placement, ESWL, and laser lithotripsy, all of which are minimally invasive and leverage advanced technology.

Introduction

Kidney stones are a common issue faced by many, especially in Florida, where heat and dehydration contribute to their development. Dr. Amar J. Raval, a reputable urologist in Tampa, FL, at the Advanced Urology Institute, shares his approach to diagnosing and treating kidney stones, leveraging the latest technology and minimally invasive techniques.

Symptoms of Kidney Stones

Patients with kidney stones usually experience a sudden onset of flank pain that doesn’t subside with oral medication, nausea, vomiting, fever, chills, and blood in their urine. These symptoms often prompt them to seek medical attention and undergo imaging tests to identify the presence of kidney stones.

Diagnosis of Kidney Stones

When a patient presents with symptoms indicative of kidney stones, Dr. Raval employs imaging tests, such as X-rays, ultrasounds, or CT scans, to visualize the stones and assess their size, location, and possible obstruction. This information is crucial in determining the best course of treatment for the patient.

Treatment Options for Kidney Stones

Dr. Raval emphasizes that modern technology has significantly advanced kidney stone treatment, offering several minimally invasive approaches:

  • Stent Placement: A temporary stent may be inserted into the ureter to bypass the stone and alleviate pain. This procedure is often performed when the stone is too large to pass naturally or is causing severe symptoms.
  • Extracorporeal Shock Wave Lithotripsy (ESWL): This non-invasive technique uses shock waves to break the kidney stone into smaller pieces, enabling the patient to pass them more easily through the urinary tract.
  • Laser Lithotripsy: In this minimally invasive procedure, a ureteroscope is inserted through the urethra and bladder to reach the stone. A laser is then used to break the stone into tiny fragments, which can be passed naturally or removed using a small basket-like device. A sample of the stone may also be sent for analysis to determine its composition and help prevent future stone formation.

Advanced Urology Institute: Your Partner in Kidney Stone Treatment

At the Advanced Urology Institute, the largest urology practice in Florida, Dr. Amar Raval and his team of skilled professionals are committed to providing the highest quality care for patients with kidney stones. Leveraging cutting-edge technology and innovative treatment options, they ensure that patients can overcome this painful condition with minimal discomfort and a swift recovery.

TRANSCRIPTION:

My name is Amar J. Raval and I’m with Advanced Urology Institute. So kidney disease is very prevalent in Florida because of the heat, lack of hydration being a huge factor. You know, patients generally present with acute onset flank pain that’s, you know, doesn’t resolve with oral medication, nausea, vomiting, fevers, chills, even blood in their urine. Then they ultimately get some sort of imaging that shows that they have a stone that may be obstructing and causing them this discomfort. Approaches are very simple and they’re very endoscopic, don’t require any incisions whether it’s leaving a stent to bypass the stone or if you’re going to treat the stone you can use shock waves from the outside to blast it or a laser to finely fine tune the stone and take a piece of it and send it as a specimen to know what kind of stone it is. So technology is certainly advanced in the realm of kidney stone disease and there’s a lot of minimally invasive approaches to be able to treat that.

REFERENCES:

Why Southerners Have a Higher Risk of Kidney Stone

I am Ketan Kapadia. I’m with Advanced Urology Institute and a board certified urologist.

Dr. Ketan Kapadia of St Petersburg, FLObviously the heat is going to play a major role, a lot of it has to do with our diet unfortunately as well. [As with] an American diet, we just don’t eat very well, we’re all a little heavier and that also increases the risk of kidney stones as well.

The interesting thing here in Florida, which isn’t talked about very much and this is sort of the holistic treatment of the patient in urology, which is we get a lot of men who have prostate problems who start cutting back on their fluids because they don’t want to get up at night; And when you start cutting back on fluids and not getting up at night, now you’re at more risk of [getting] stones. We see a lot of older guys who come in with kidney stones for the very first time because they got a prostate problem as well and that hasn’t really been addressed.

Same with women who have overactive bladder. First thing most people do is they start cutting back their fluid so they’re not having to run to the bathroom all the time. Again, you cut back your fluid and now you’re living in Florida in the heat, you’re going to get kidney stones. So a lot of doctors will be more than happy to just get rid of your stone and have the surgery [but] I’m also interested in preventing that next stone. Part of that is getting twenty-four (24) hour urines, seeing why you’re making stones, addressing all the overactive bladder problems and prostate problems because I don’t want you to end up having more stones. I’m happy to operate and take out stones, that’s fun, but it’s my obligation to help prevent [it from happening agan].

Urologists Also Treat Women

Urologists are physicians who specialize in treating the male and female urinary systems, as well as the organs of the male reproductive system. Because men and women can both have problems with their urinary tract systems, many women see urologists for treatment. According to board certified urologist Dr. Howard Epstein, “We usually see women for things like bladder cancer, kidney stones, kidney cancer or incontinence.” Recurring urinary tract infections is another common reason for women to see a urologist.

Although both men and women see urologists, they usually see urologists for different reasons. For instance, women are more prone to urinary incontinence. Urinary incontinence is the loss of bladder control which can cause urine leaks. The degree of the severity of incontinence varies on a case-by-case basis. Some women experience urinary leakage when they laugh, cough or exercise. Urinary incontinence is so common in women that at least half of older women experience some degree of it. Urologists can treat incontinence with a wide range of options, including lifestyle changes, medication, devices, and in some cases surgery.

Urinary tract infections Howard Epstein, MD of St Augustine, FL(UTIs) are another issue that brings many women, especially older women, to their urologist’s office. UTIs are another urinary issue that can affect both men and women, but they are far more common in women than men. About half of all women will have a UTI in their lifetimes, while only 1 in 10 men will. UTIs are infections that happen in the bladder or urethra. Symptoms include burning while urinating, frequent urges to urinate, and pain in the lower back and abdomen. Urologists can prescribe antibiotics to treat the infection.

Kidney stones are another issue for which women seek help from their urologist. These stones, made of salt and mineral deposits in the kidneys, can become lodged in the urinary tract causing a wide range of issues. Symptoms include pain, nausea, vomiting, and even fever. In some cases, the pain can be so severe that some women liken it to childbirth, if not worse. There are several treatment options available for kidney stones, and finding the right one depends on the size and location of the stone. Shock wave lithotripsy can be used as a non-invasive way to break up the stones into small, easily passable pieces. In some cases, more invasive extraction methods might be needed.

All of these urological treatment options, from medications to surgeries, have their side effects. It is important for women to be able to have conversations with their urologist about their health issues and the possible side effects of treatment. For many women with urinary problems, the path to relief begins with a consultation with a urologist at the Advanced Urology Institute.

What are the different treatment options for kidney stones according to Dr. Samuel Lawindy?

KEY TAKEAWAYS:

  • Shock wave lithotripsy is a non-invasive and relatively pain-free treatment option for kidney stones, where shock waves are used to break the stones into small sand-like particles that can be passed naturally through urine.
  • Ureteroscopy is a more invasive option for kidney stones, involving the use of general anesthesia and a long tool inserted into the urethra to find and remove the stones, with larger stones being broken up using a laser.
  • For the largest stones that sit inside the kidney, a minimally invasive procedure may be required, where the urologist enters the kidney through the patient’s back to break the stone up or remove it through the incision, with recovery involving an overnight stay at the hospital.

Kidney stones are hard deposits of salts and minerals that form in the kidneys. They are a common and sometimes acutely painful occurrance that affects both men and women. Sometimes these stones can pass from the kidneys and become lodged in the tubes that connect the kidney to the bladder, called ureters. When this happens, kidney stones can become a big problem, causing painful symptoms that may require medical treatment.

Dr. Samuel Lawindy of Daytona Beach, FL

Acute kidney stone symptoms include pain, nausea, vomiting and fever. When a patient experiencing an acute kidney stone episode sees their urologist, the first thing the urologist will do is insert a stint into the urethra. This will open it up and take pressure off the kidney, easing any pain that is present. With the pain subdued, the urologist can move on to assessing the kidney stone’s size and location in order to decide the best treatment option.

One of the best and newest treatment options is shock wave lithotripsy. For this treatment, shock waves are used to break the stone, or stones, into small sand-like particles. These much smaller particles are easier for the patient to pass naturally through their urine. Lithotripsy is a non-invasive and relatively pain free treatment option that is generally well tolerated by the patient.

Ureteroscopy is a slightly more invasive option for kidney stones. General anesthesia is used for this procedure in which a urologist uses a long tool inserted into the urethra to find and remove the kidney stone. In cases of larger stones, a laser is used to break up the stone so it can be scooped out with the tool. With this procedure, the urologist can see the stones as they are removed. Since this is a more invasive option than the shock wave lithotripsy, there is a slightly longer recovery time.

For the largest stones that sit inside the kidney, urologists may need to remove them through the patient’s back. Although still minimally invasive, it is the most invasive option listed here. The urologist will enter the kidney through the back and then either break the stone up or pull the whole thing out through the incision. Recovery for this procedure usually involves an overnight stay at the hospital and some mild pain that can be helped with pain medication.

Patients experiencing the pain and discomfort of kidney stones should be reassured that there are several established procedures for removing the stones. Dr. Samuel Lawindy of the Advance Urology Institute knows the importance of finding the right kidney stone treatment for each patient. For more information about kidney stones, visit the Advanced Urology Institute website.

TRANSCRIPTION:

So my name is Samuel Lawindy, I’m a board certified urologist at Advanced Urology Institute.

If you have an acute stone episode where you come in with a lot of pain, nausea, vomiting, fevers, the first step is to place a ureteral stent.
The stent will decompress the kidney, open it up, relieve the pressure, relieve any kind of infection that may be there, and take away the pain most importantly.

Once that’s in, then we have time to figure out what the next best option is in regards to treatment. So when talking about kidney stones, based on the size of the stone, the location of the stone, you can do anywhere from shockwave lithotripsy, where you break up the stone with sound waves, very minimally invasive, very well tolerated.

Next option is something called ureteroscopy, where we go in through the urethra from below all the way up to the location of the stone, and break it up with a laser.

And then we can pull those pieces out so it’s a little bit more definitive, in that we see the stone and remove it with an actual basket, however it’s a little more invasive so there’s a little bit more recovery time.

Lastly there is the larger stones that can sit inside the kidney that would be required to remove through the back, and that’s usually done in an overnight hospital stay, still relatively minimally invasive, but we go in through the back to the kidney, either break up the stone in small pieces and pull them out, or we can just grab the whole thing out and pull it out there.

For PCNL, recovery is usually an overnight stay at the hospital, there is a tube in the back that stays in place overnight, but then you go home with nothing, you go home with no tube in the back, no catheter from below, pain is relatively mild, but well controlled with pain medication.

REFERENCES:

5 Reasons for Women to See a Urologist

A urologist isn’t just a doctor for men. There are many reasons why a woman would need to see a doctor who treats the urinary system. The urinary system is a collection of organs that involved the kidneys and bladder, as well as the organs involved in the reproductive process.

Here are five common reasons why a woman may need to see a urologist

1. Kidney Stones

When minerals in the urine combine, they can sometimes stick together and create kidney stones that get lodged in the urinary tract. These stones vary in size and create a variety of symptoms. The most common symptoms are pain and difficulty urinating. Some women may also experience fever or chills.

Treatment for kidney stones varies depending on patient and stone type, but urologists have plenty of treatment options on hand. In some cases, drinking lots of water can flush the stones out. In other cases, high-intensity focused ultrasounds can break the stones into smaller, more easily passable pieces.

2. Urinary Tract Infection

Commonly referred to as UTI, this a common infection that many women will develop at some point in their lives. It occurs when bacteria enter the urinary tract and cause pain and burning during urination. UTI’s can become serious, so treatment with antibiotics is important.

3. Bladder/Pelvic Prolapse

This painful condition occurs when the bladder begins to drop down into the vagina. There are a few reasons why this may happen. Some women develop this condition after childbirth, but for others it occurs as a part of the aging process. Correcting this problem usually requires surgery performed by a urologist.

4. Bladder Control Problems

Bladder control problems are twice as common for women, and the medical term for these problems is Urinary Incontinence. Urinary incontinence takes many forms. Some women experience dripping when they sneeze, cough or laugh. Some women have an overactive bladder that creates a sudden and urgent need to use the bathroom. No matter what form it takes, women can work with a urologist to find the best treatment, or combination of treatments, to help with their incontinence.

5. Cancer

There are certain cancers for which a woman would be treated by a urologist. These include cancers of the bladder, kidneys or urethra. Lower back pain, pain during urination, and blood in the urine can be signs of one or more of these cancers. Treatment varies depending on the type of cancer, how aggressive it is, and the overall health of the patient.

Women in Florida who need a urologist for treatment of one or more of these problems have many options. The Advance Urology Institute is a team of highly skilled medical professionals who practice at locations throughout the state and with a commitment to achieving the best possible outcomes for their male and female patients. For more information about women’s urological issues, visit the Advance Urology Institute website.

Ways to Pass Kidney Stones

Kidney stones can be a painful and difficult experience for the many men and women who get them. These stones are hard deposits of minerals that build up in the body and cause blockages in the urinary tract. The blockages can make it very painful and difficult to urinate. In addition to difficulty urinating, the stones can cause nausea as well as pain in the groin and abdomen. Luckily, there are many ways that urologists can help speed up the process.

Quynh-Dao Tonnu, PA-C: Physician Assistant in DeLand, FLFinding the best way to help a patient to pass a kidney stone depends on several factors. Not all patients are the same, and the size and difficulty of their kidney stones vary as well. If the stones are smaller than 5 millimeters, the urologist will want the patient to try and pass them naturally. This is the least invasive way to pass kidney stones, although it may not always be possible. Drinking lots of liquids for frequent urination is the key for this method. Urologists may also recommend movement like bicycling and jumping jacks to help dislodge the stones naturally.

If passing naturally is not an option, then medication may be the next step. Urologists will use some of the same medications that are used to treat an enlarged prostate. Medication like Flomax helps relieve pressure on the urinary tract by relaxing the muscles in the prostate. This allows for easier urine flow and can help the patient pass the stones.

Another treatment option that makes passing stones easier is called shock wave lithotripsy. This treatment uses a machine pressed up against the patient’s body that targets water waves directly at the kidney stones. With as many as 2,500 waves per treatment, these waves break the kidney stones into small, sand-like particles. The sandy remnant is then easily passed during urination.

In some cases, a more invasive treatment may be needed to remove the stones from the body. A surgeon may use a scope fitted with a medical laser to enter the patient’s urinary tract through the penis. They can then use the laser to break the stones up into smaller fragments for easier passing. This method is sure to help pass the stones, but a urologist may prefer to try more natural methods first.

There is no single method to passing kidney stones. What matters most is making the process as fast, safe and pain-free as possible. For more information about kidney stones, visit the Advance Urology Institute website.

Kidney Stones: Who is at Risk

Kidney stones are a common medical issue that arises when hard deposits of minerals form in the kidney and can affect the urinary tract. These stones can cause severe pain in the abdomen and groin, nausea, and pain during urination. Kidney stones have no single or set cause. Anyone is at risk of developing kidney stones at some point in life.

Dr. David Harris of Fort Myers, FLAlthough anyone can develop stones, there are certain factors that can indicate who gets them and how they occur. As urologist Dr. David S. Harris states, “There are certain features of a person’s stone history that are predictors to us if they’re going to have more stones.” A patient suffering from kidney stones will want to consult a urologist to see what can be done to limit the chances of developing kidney stones in the future.

A urologist may want to do a urine or blood analysis to see if there are any reasons for a patient to develop kidney stones. A urologist also may want to address some common risk factors for kidney stones. For instance, dehydration is a very common cause of kidney stones. For this reason, people who live in warm climates and are at greater risk of dehydration are also at greater risk of developing kidney stones. A urologist may recommend that someone living in a warm climate like Florida drink plenty of fluids every day.

People with diets high in salt, protein and sugar are also at increased risk of developing kidney stones. Too much salt especially increases the amount of calcium a person’s kidneys must filter, increasing the chances of stone development. Obesity also increases the risk of developing kidney stones, so weight management is something a urologist will strongly recommend if that is a factor.

Beside dehydration and dietary choices, genetics can play an important role in an individual’s risk of developing kidney stones. If someone in your family has kidney stones, then you are more likely to develop them as well. And once you develop kidney stones you are at a greater chance of developing stones in the future. For this reason, in addition to adjustments in water intake and diet, urologists sometimes will recommend medications.

Just because someone has had kidney stones before doesn’t mean they will have to suffer with them the rest of their lives. At the Advanced Urology Institute, doctors work with their patients to find and correct root causes for kidney stones. For more information, visit the Advanced Urology Institute website.

Kidney Stones Pain, Symptoms and Treatment

Kidney stone disease is a common issue that affects men and women alike. There are many factors that can be attributed to developing kidney stones. According to Dr. Amar J. Raval, “Kidney stone disease is very prevalent in Florida because of heat and lack of hydration.” The state’s warm climate helps induce sweating and makes it easier to dehydrate, putting people who live there at a higher risk of developing stones.

In addition to climate, there are several other factors that can increase kidney stone likelihood. Family history is one factor. If someone in your family has a history of developing stones, you are at greater risk of developing them as well. Diets high in protein, salt and sugar also increase the risk. Salt especially is known to increase the amount of calcium your kidneys must filter, raising the chances of stone development. Certain conditions like irritable bowel syndrome and urinary tract infections are also known to increase kidney stone risk.

Urologist Dr. Amar Raval of Palm Harbor, FLThere are numerous symptoms associated with kidney stones and they can vary in seriousness and pain level. Doctors often see patients with acute onset pain in the upper abdomen that does not resolve with medication, nausea, fever, chills, difficulty urinating and even blood in the urine. The symptoms of kidney stones may present themselves differently depending on many different factors. It is important to know when something is not right and when it may be best to see a urologist for help.

Luckily for people suffering from kidney stones, there are many treatments doctors can use to help them. Many of the treatments are endoscopic, not requiring incisions and are minimally invasive. For instance, doctors may insert a stint into the urinary tract to allow the patient to pass the stone. Shock waves also can be used to break large stones into smaller more easily passable pieces. The shock wave treatment also is not invasive. Doctors can use lasers to break off a piece of the stone for a biopsy to determine exactly what kind of stone it is and what the best treatment may be.

Consulting a trusted urologist for diagnosis and treatment options for kidney stones is very important. Like many conditions, kidney stone treatment is easiest when caught early. Urologists like Dr. Amar J. Raval at the Advanced Urology Institute help many patients with kidney stones. They are familiar with kidney stone disease as well as the latest medical technology, and can provide the most advanced treatment options for their patients. For more information, visit the Advanced Urology Institute website.

Kidney stones: What are the treatment options?

If you’ve been diagnosed or suspect you have kidney stones, you will want to know about your options for treatment right away.

Kidney Stones: What are they?

Kidney stones are technically referred to as renal calculi. They are solid entities formed of different types of crystals. When they become large, they are extremely painful. They are called kidney stones because they usually start forming in the kidneys, but they can develop anywhere along the urinary tract, including

  • kidneys
  • ureter
  • bladder
  • urethra

What Causes Kidney Stones?

Kidney stones have several variations, and they originate for different reasons. Some of the causes are:

  • Calcium. Calcium-based stones are the most common type and somewhat preventable by avoiding high oxalate-rich foods like potato chips, peanuts, chocolate, beets and spinach. Ironically, although some kidney stones form from calcium, getting sufficient calcium in your food can prevent these stones.
  • Uric acid. These kidney stones are found more often in men than women. They develop when the urine becomes too acidic due to a diet high in purines (animal proteins) like fish, shellfish and some meats.
    Struvite. Struvite stones are more often found in women who have urinary tract infections or a kidney infection.
  • Cystine. Cystine stones are less common. They are hereditary and caused by leakage of cystine into the urine from the kidneys.

What Treatment is Available for Kidney Stones?

If the stones don’t go away by passing naturally through the urogenital system, you should contact a urologist for treatment. There are several procedures they can employ to remove the stones. The type of treatment depends on the size of the stones and type of stone.

Here are some treatments your urologist might recommend:

  • Medication: The urologist may prescribe pain medications and/or antibiotics in case of an infection. Other medicines also may be prescribed depending on what type of kidney stone is found, including: allopurinol for uric acid stones; diuretics to avoid calcium stones; sodium citrate or sodium bicarbonate, which makes the urine less acidic; or phosphorus solutions which are found to prevent calcium stones from forming.
  • Modern methods of breaking up the stones like lithotripsy, in which sound waves are employed, so stones are more easily passed.
  • Tunnel surgery is a minimally invasive procedure in which the urologist makes a small incision on your back to retrieve the stones.
  • Ureteroscopy: If a kidney stone is lodged in the bladder or ureter your urologist may use a ureteroscope to retrieve it. In this procedure a thin wire with an attached camera is inserted into the urethra and bladder, and then the stones are retrieved. Stones are examined by a lab to give more insight into the type of stones being formed.

Kidney Stone Prevention

If you are prone to kidney stones, try to drink 6 to 8 glasses of water each day to increase urine flow. This preventative measure helps flush out the kidneys. Your urologist may prescribe medication to help prevent future types of stones from forming.

If you think you have kidney stones you will want to speak with a qualified doctor to discuss the best methods to prevent and treat them. If you are in Florida, call the Advanced Urology Institute for an appointment with a board certified urologist.

How to Treat Kidney Stones with Dr. Rolando Rivera?

KEY TAKEAWAYS:

  • Treatment for kidney stones varies depending on their size, type, and location. Small stones can typically be passed with hydration and medication, while larger stones may require more extensive treatment like lithotripsy or surgery.
  • Lithotripsy, a non-invasive procedure, uses high-energy shock waves to break larger kidney stones into smaller pieces, allowing them to be passed during urination. This treatment has largely replaced surgical removal of stones.
  • Preventing kidney stones involves drinking plenty of water, reducing intake of oxalate-rich foods, limiting dietary salt and animal proteins, and taking medications to target specific types of stones.

Treatment of Kidney Stones

The treatment available for kidney stones varies according to the size and type of kidney stone and its location.

If the stones are small, they probably won’t require invasive treatment and can be passed with hydration and medication like pain relievers and alpha blockers that relax the muscles in your ureter. This is how most kidney stones are resolved.

Dr. Rolando RiveraIf you have large stones, however, your urologist may approach them with more extensive treatment. There are several ways to eliminate them. If you have severe pain, an infection, or your kidney function is threatened, your doctor will want to act quickly. Fortunately, during the 1980s a new approach to getting rid of the stones appeared on the medical scene and quickly replaced surgical removal of the stones. This treatment, called lithotripsy, uses sound waves to break larger kidney stones into tiny pieces so they can be passed during urination. These sound waves are also called high-energy shock waves and are usually implemented from outside the body in what is called “extracorporeal shock wave lithotripsy” or ESWL. The procedure takes about 45 minutes to an hour and you may be put under light sedation during treatment.

If the stones are larger and located in the kidney, or if ESWL did not break them down, your urologist may perform surgery to remove them. Your doctor can explain the surgical approach he recommends.

What Causes Kidney Stones?

Calcium phosphate stones are caused by overactive parathyroid glands which are located below your Adam’s apple. When these glands overproduce the parathyroid hormone the result is hyperparathyroidism, resulting in an excess of calcium that may cause kidney stones. Your doctor likely will recommend treatment to stop your parathyroid gland from overproducing the hormone.

Prevention of Kidney Stones

You may lower your risk of kidney stones if you:

  • Drink large amounts of water during the day. If you are in a dry environment or exercise significantly, you may need even more water, drinking enough so your urine looks almost clear.
  • Consume fewer oxalate-rich foods. If your doctor determines you have calcium oxalate stones, he may recommend dietary changes to reduce foods that are high in oxalate, like beets, spinach, sweet potatoes, tea, chocolate, nuts and soy products.
  • Reduce your dietary salt and consumption of animal proteins.

Medications

Medications may help prevent kidney stones, depending on the type of stone. Uric acid stones, calcium stones, cystine stones and struvite stones each require a different plan for prevention.
If you reside in Florida, you are probably not far from an Advanced Urology Institute location. If you are near Naples or Bonita Springs, you may wish to consult with Dr. Rolando Rivera for your kidney stone symptoms and treatment. For more information, visit the Advanced Urology Institute website.

TRANSCRIPTION: 

I’m Rolando Rivera and I’m board certified in Urology and Female Public Medicine and Reconstructed Surgery with Advanced Urology Institute.

The treatment options will depend on the size of the stone and the location. The smaller the stone, the more likely that we would recommend a trial of passage because the majority of them can pass on their own with appropriate hydration and medications. The bigger stones we would treat with either endoscopic procedures with lasers or shockwave therapy, depending, and other stones can be treated with external shock wave literacy as well. Really big stones that are really hard can be accessed directly, externally, whether they’re in the kidney, through the back, or with other robotic surgeries as well.

REFERENCES: 

What Causes Kidney Stones by Dr. Howard Epstein

What causes kidney stones? This is a question that Dr. Howard Epstein hears often when he meets patients suffering from the symptoms, pain and problems caused by this common urological condition.

It is important to first know what the kidneys are and what is their normal function. The kidneys are often described as fist-sized, bean-shaped organs. They are located below the ribs, behind the stomach. Their main function is to filter the blood and maintain the proper balance of necessary salt, water and various minerals in the blood. Excess salt and minerals and other wastes are removed and sent to the bladder as urine. The filtered blood is sent to the heart, where it can carry oxygen and necessary nutrition to the rest of the body. Because the kidneys essentially make sure the blood is clean and healthy, they are critical for life.

Dr. Howard EpsteinFor a normal person, the kidneys will filter around 200 quarts of blood each day, and they will remove about two quarts of liquid each day in the form of urine. Since a healthy person of around 160 pounds has only five quarts of blood, that means the blood will flow through the kidneys around 40 times per day.

Of all the various ailments a person can have, kidney stones can be among the most painful. The stones are formed when the kidneys filter out an excessive amount of minerals, such as salt or calcium, and those minerals remain in the kidney long enough to start crystallization. It’s the same kind of process that can create rock candies. Over time, the crystals become larger, forming kidney stones. If they are small, they can often be flushed out (passed out) of the kidneys and the body without creating any problems. But if at any stage they get stuck in the body, they will continue to grow in that spot. The most common spot is in the kidneys, where they first start growing. As they grow, they hinder normal kidney function, reducing the flow of blood and reducing the kidney’s ability to produce and pass urine. A kidney stone can move and completely stop the flow of urine, which is really bad news.

If a person consumes too much salt, too many calcium-containing foods, takes certain medications or drinks far too little water, kidney stones can develop. There is evidence that genetics also can can cause stone-making kidney disorders. The end result can be very painful.

Drinking water every day is essential to good health. The citrate in lemon juice can be beneficial in small amounts. Artificially colored sodas and food, as well as too much coffee, can cause problems because of the types of chemicals that enter the body. The body also gets rid of excess water through perspiration, so it is important to drink enough water to urinate at least four times a day, with an average above that.
Anyone experiencing symptoms such as strong pains in the stomach area or on the side down to the groin should immediately see a doctor. There are numerous problems that can cause excessive side or abdominal pain and it is advisable to see a specialist. If you are concerned about the possibility of having kidney stones, schedule a consultation with Dr. Howard Epstein MD or one of the many highly skilled urologists at an Advanced Urology Institute location near you.

What Causes Kidney Stones

Kidneys perform the function of filtering blood to remove waste from it. This waste is mostly water that contains salts such as sodium, calcium and potassium, all collectively referred to as urine. Kidney stones form when these salts are so concentrated in the urine that they crystallize into clumps, that can be as small as a grain of sand or larger.

Ordinarily a kidney stone causes no symptoms until it begins to move in the kidney or to other parts of the urinary system. A small kidney stone can be passed painlessly by urination. Bigger kidney stones, however, can be very painful to pass. But kidney stones are treatable and treatment should help you avoid the painful experience.

Causes of Kidney Stones

Kidney stones result from the clumping together of salts. Most kidney stones are calcium oxalate stones that form from calcium salts and oxalates. Oxalates occur naturally in some fruits, vegetables and nuts. There are also uric acid stones, which form due to lack of fluid in the body or a significant loss of fluid. Risk factors for the formation of kidney stones include:

1. Lack of Water/ Dehydration
This is without a doubt the most common cause of kidney stones. Stones form when urine salts occur in very high amounts in urine. Drinking adequate amounts of water can dilute the urine and reduce the concentration of salts. People in hot areas should take special care to drink a lot of water because they lose a lot of it in perspiration.

Dr. Rolando Rivera 2. High sodium diet
Many kidney stones have an element of calcium. Too much sodium increases the amount of calcium that kidneys have to process, thereby making it more likely for stones to form. Animal proteins such as red meat and shellfish, also have a reputation for making urine acidic, thereby increasing the possibility of having uric acid stones.

3. Personal or family History
A person who comes from a family with a history of having kidney stones is at an increased risk of having them. Similarly, a person who has had kidney stones before is very likely to suffer a recurrence.

4. Digestive illnesses and surgery
Serious inflammations of the digestive system, chronic diarrhea and gastric bypass surgery all can negatively affect the absorption of fluids and calcium by the body. This makes it more likely for the patient to have kidney stones.

Kidney stones are very common despite the fact that they can be prevented by staying hydrated and watching your diet. If you have them, you should consult a doctor immediately so treatment can be administered promptly. The Advanced Urology Institute offers effective treatment for kidney stones. Its staff of specialists are available to help with diagnosis and treatment and can answer any questions about prevention of kidney stones. For more information, visit the Advanced Urology Institute website.

Symptoms of Kidney Stones -Beyond the Basics


Kidney stones occur when hard deposits (minerals and salts) form inside the kidney. They vary in size and may travel to other parts of the urinary tract. While small stones may not produce any symptoms, some people complain of severe pain in different parts of the body. The excruciating pain can be likened to that of childbirth. Here is a quick guide on common symptoms of kidney stones.

1. Urge to urinate or frequent urination

Most people with kidney stones feel the urge to urinate. However, this will depend on where the stone is located. Those that are close to the bladder can irritate the walls and make the patient feel an urgent need to use the bathroom. These contractions may even occur when the bladder is empty. Keep in mind that unless the stone has moved to the urethra, there is no trouble when urinating.

2. Pain in the groin, back or side

Patients who experience pain around the groin or the lower abdomen may need a diagnosis for kidney stones. The pain also can occur under the rib cage or on the back side. It starts as a dull ache that escalates to sharp wincing pain. And it’s very episodic – it can be severe one minute and then completely subsides. The pain may be mild or barely noticeable. The patient may need to seek medical attention if the pain is very intense.

3. Nausea and vomiting

These two symptoms occur when the stones interrupt the flow of urine. It’s worth mentioning that stretching of the kidneys can cause gastrointestinal upset. And the worst part is that this pain does not subside even after making changes in body position. When patients vomit, they get dehydrated so additional fluids are recommended.

4. Blood in the urine

In advanced stages, a kidney stone can cause blood in the urine. The blood is only visible with dipstick testing or when examined with a microscope. People who spot pink or reddish urine should see a urologist immediately. Sometimes the urine may look like tea. This could be an underlying symptom to a more serious condition.

5. Fever

While this is not a common symptom for kidney stones, it occurs when patients have an infection in the problem area. According to experts, fever can occur when the stones block the flow of urine, which could be an emergency situation. And because the antibiotics can’t penetrate to an obstructed kidney, the obstruction must be relieved. Fortunately some stones may pass on their own without treatment.

Need the services of a urologist? Visit Advanced Urology Institute for professional treatment. Here you’ll find Dr. David Burday and other practicing urologists. They will do their best to put you at ease. For more information on treatment of kidney stones and other urological problems, visit our “Advanced Urology Institute” site.

Kidney Stone Causes, Symptoms, and Treatments

There are a lot of kidney stone cases in Florida, thanks to dehydration from the extremely hot weather and diets that include a lot of tea, meat, salt and other highly rich foods associated with the stones. While about 10 percent of Americans may expect to have a kidney stone at some point in their lives, the likelihood rises to 15 percent for people living in the South. Stones are formed when minerals and other substances found in urine crystallize, usually in people who are dehydrated or don’t consume enough fluids.

Symptoms of kidney stones

At Advanced Urology Institute, we see a lot of patients with kidney stones. A contributing factor is our location in Florida, with its massive heat and humidity which leads to dehydration and, unfortunately, to the formation of these painful stones in the kidneys. The stones commonly present with severe, intense pain — like something is stabbing you — and you can barely walk. Kidney stones are characterized by sharp pains in the side or back as they make their way to the bladder. Most of our female patients usually say the stones are more painful than labor pain. Other symptoms of kidney stones include vomiting, nausea, a constant urge to pass urine and blood in urine.

Pain from kidney stones is often sudden in onset, though it may get severe over a period of hours in some cases. The pain may be either intermittent (colicky) or steady and, depending on the stone’s location as it moves through to the bladder, it may begin in the back or flank area and radiate slowly downward to your inguinal ligament, urethra, bladder, testicles or penis. Urinary or bladder symptoms, such as frequency of urination and painful urination, may occur if the stone is located in the portion of your urethra found within the bladder wall. Not all stones cause pain and some of them are often discovered “incidentally” during pelvic or abdominal X-rays. But in patients who experience pain, they usually describe it as the worst pain they have ever experienced.

Diagnosis of kidney stones

Diagnosis of kidney stones is almost entirely based on the history of passing the stones or on occurrence of a stabbing pain in the side or back. We usually place emphasis on the patient’s clinical signs, familial disorders, presence or absence of any previous renal stones, or physical exam findings. We also perform a urinalysis to check the presence of white cells (pyuria) or blood (hematuria) in urine, a culture of urine to exclude infection, and use the presence of crystals in urine (crystalluria) to help identify the stone type. Patients are often required to strain their urine to obtain the stone for crystallographic analysis. Analyzing kidney stones for their mineral composition helps us understand your future risk and to recommend the right dietary habits and restrictions for preventing stones. But we also do a CT or CAT scan of the pelvic and abdominal area to evaluate the size, location, degree of hydronephrosis and density of the stone, all of which are important in determing how we treat and manage the stones.

Treatment

When patients complain of symptoms of kidney stones, we usually do physical exams and run tests to confirm that they actually have stones. But we often begin by getting the pain under control and calming the patients, to enable us to discuss with them available treatment options. The pain due to kidney stones is relieved using pain medication, drinking plenty of fluid to prevent dehydration, and ordering bed rest. In many cases once we have assessed that the stones can pass on their own, we allow about 7 days for them to pass spontaneously. In other instances, however, kidney stones may need to be broken down into tiny pieces or to be removed surgically.

At Advanced Urology Institute, we break up kidney stones using such techniques as percutaneous lithotripsy, cystoscopy or extracorporeal shock-wave lithotripsy. For renal stones less than 2cm in size, we generally treat them using extracorporeal shock-wave lithotripsy. During the procedure, high-intensity ultrasound (shock-waves) are passed through pouches of water placed on the skin and then directed toward the stone. The waves break the kidney stones into tiny pieces that can pass easily through the ureter. For stones located higher in the ureter or in the bladder, we often use cystoscopy to pull them out or break them up with electric energy or laser. During the procedure, the doctor passes a viewing tube with a crushing device into the ureter or bladder to pull the stone out or break it up with electric energy or laser.

For larger stones, percutaneous nephrolithotomy is a safe and reliable technique. For this procedure, you’ll be given medication to sedate you, then a viewing tube will be inserted through an incision made in your side. Once the stone is reached, it’s broken up using electric energy or ultrasound. In cases where this procedure doesn’t work, particularly when the stones are hard to reach or too large, surgery is often the preferred treatment. Surgery to remove kidney stones is performed under general anesthesia with the doctor making an incision into the side and another into the kidney or ureter to remove the stone. After the stone is removed, the incisions are stitched up.

There are many ways of treating kidney stones and the method chosen usually depends on the experience and judgment of the urologist, together with the patient’s preferences. At AUI, we prioritize the comfort of our patients, so we opt for the least invasive procedures before considering surgery. Want to know more about prevention, diagnosis and treatment of kidney stones? Find more information from the “Advanced Urology Institute” site.

How are Kidney Stones Treated?

Kidney stones are a common cause of agonizing and debilitating pain in men and women. In the United States, the stones account for over one million hospital visits and more than 300,000 emergency room visits every year. When patients present with kidney stones, the treatment administered usually depends on the type, size and location of the stone and on the severity of symptoms. Apart from administering treatment, the urologist investigates the underlying cause of the stones and recommends ways of preventing a recurrence.

Spontaneous passage

Kidney stones smaller than 4 mm in diameter are often passed on their own in urine and may be treated at home. While such stones may be painful, the pain often lasts only a few days and usually disappears soon after the stone is passed. So, depending on how bad your symptoms are and how long you’ve had the symptoms, you may not be given any form of treatment and just wait for stones to pass in urine. It usually take up to six weeks to do so.

However, you should only do this if the pain is bearable, there is no sign of infection or kidney blockage and the stone is of a size that can pass on its own. As you wait for it to pass, you’ll need to drink plenty of water and take pain medication to help you manage the discomfort. If you suspect that you have a kidney stone, speak with your doctor to see if you need immediate treatment or if you can wait for it to pass spontaneously.

Medications

There are a number of medications that increase the chance of passing kidney stones. For instance, tamsulosin is commonly given to people with kidney stones to help relax the ureter and make it easier for stones to pass. Apart from medications to boost stone passage, your urologist may prescribe anti-emetic (anti-nausea) medication to reduce nausea and vomiting as you wait for the stone to pass. And if you are in severe pain, your doctor may give you 1-2 pain injections and then prescribe some painkillers and anti-emetics for you to take from home.

Surgical procedures

If the pain is so much that you can’t wait for the stone to pass in the urine, you’ll require a surgical procedure to remove it. Surgery is also necessary if the stone is too big to pass on its own or is hampering kidney function. Kidney stones may be removed surgically if they are causing repeated urinary tract infections or are blocking the normal flow of urine.

Surgical procedures to remove kidney stones include extracorporeal shock-wave lithotripsy (ESWL), ureteroscopy and percutaneous nephrolithotomy (PCNL). These procedures are usually chosen by urologists depending on the size, type and location of the stones.

1. Extracorporeal Shock-Wave Lithotripsy (ESWL)

This procedure is the most frequent way of treating stones that can’t pass spontaneously in urine. High-frequency waves (X-rays or ultrasound) are directed at the stone to break it into smaller pieces that can pass in urine. Often the tiny pieces require a few weeks to pass out in urine. While ESWL is 99 percent effective for kidney stones up to 20 mm in diameter, more than one session is usually necessary for the treatment to be successful.

2. Ureteroscopy

For kidney stones that are lodged somewhere in the kidney or ureter, ureteroscopy (also called retrograde intrarenal surgery) may be necessary. The procedure involves directing a long, thin telescope (called ureteroscope) through the urethra, into the bladder, then into the ureter or kidney where the stone is located. If the stone is stuck in the kidney or upper ureter, the urologist uses flexible telescopes for this procedure, but rigid telescopes are ideal for stones stuck in the lower parts of the ureter.

The ureteroscope helps the urologist to reach the stone without making an incision. After reaching the stone, the doctor either can use another instrument to remove it or direct laser energy on it to break it into smaller pieces that can pass naturally in urine. A stent (plastic tube) may be inserted temporarily into the bladder to drain out the stone fragments.

3. Percutaneous nephrolithotomy (PCNL)

For kidney stones that are too large (21-30 mm in diameter), percutaneous lithotripsy is the treatment of choice. During the procedure, a half-inch incision is made in the side or back, just big enough to allow passage of a telescopic instrument (called nephroscope) into the area of the kidney where the stone is located. The nephroscope is used either to pull out the stone or break it up with pneumatic energy (or laser) and suction out the pieces. In fact, it’s the ability to suction out tiny stone pieces that makes this procedure ideal for larger stones.

Kidney stones also can be removed through open surgery, laparoscopic surgery or robotic surgery. But this is only done when the less-invasive procedures fail. Routine surgical procedures for kidney stones require shorter recovery period and you can usually return home the same day after the procedure and resume normal activities in 2-3 days. If the urologist inserts a stent after a procedure, it is removed 4-10 days later. During treatment, you also may be provided with a strainer that you can use to collect stone pieces that pass in urine for laboratory testing and to enable the urologist to recommend appropriate ways of preventing stone recurrence.

At Advanced Urology Institute, we offer shockwave lithotripsy, ureteroscopy and percutaneous nephrolithotomy routinely, and perform robotic and laparoscopic procedures for kidney stones when necessary. We perform blood tests and 24-hour urine analyses for every patient to identify the cause of kidney stones in order to provide the right treatment. We also design prevention strategies tailored to each patient, including personalized dietary recommendations based on results of 24-hour urine analysis. Our aim is to always ensure that our patients properly understand why they have kidney stones and make the necessary lifestyle changes to prevent a recurrence. For more information on kidney stones and how they are managed, visit the “Advanced Urology Institute” site.