Kidney / Ureteral Stones

Each year, more than a million kidney stone cases are diagnosed—and it’s estimated that 10 percent of Americans will suffer from kidney stones at some point in their lives. If you’re suffering from urolithiasis, or “stone disease,” likely you take little comfort in knowing you’re not alone. The good news is most stones pass out of the body without any intervention. But if you’re not so fortunate, you can turn to Urological Associates in Iowa City, considered among the best urology specialists in Iowa.

Symptoms of Kidney Stones

Stones form in the urinary tract. Over time, they grow and may change location within the kidney. While urine flow may wash some stones out of the kidney, others can get trapped within the ureter, blocking the outflow of urine from the kidney to the bladder. That can result in:

  • Extreme pain: The pain often comes on suddenly as the stone moves into the urinary tract, thus causing irritation and blockage. That can result in a sharp, cramping pain in the back, near the area of the kidney or in the lower abdomen, and can spread to the groin. The extent of your pain isn’t tied into the size of the stone. Some stones as small as 2mm have passed causing many symptoms while pea-size stones have passed quietly.
  • Blood in your urine
  • Nausea and vomiting
  • Dull ache: Occasionally stones do not produce symptoms. Though “silent,” these stones can be growing and causing irreversible damage to your kidney function. Stones that aren’t large enough to prompt major symptoms can still trigger a dull ache that can be confused with muscle or intestinal pain.
  • Burning during urination: If the stone is too large to pass easily, pain continues as the ureter tries to squeeze the stone along into the bladder. You may feel the need to urinate more frequently or you might feel a burning sensation while urinating. If you’re a male, pain may move to the tip of the penis. If the stone is close to the lower end of the ureter at the opening into the bladder, you might feel like you have not fully completed urination.
  • Fever or chills: If you experience fever or chills, you may have an infection. Please contact your urology specialist at Urological Associates immediately.

Diagnosis of Kidney Stones

Through these tests, your urology specialist can determine the size, location and number of stones—important factors in determining the best treatment:

  • X-ray: “Silent” stones—the ones that cause no symptoms—may be found on X-rays taken during routine health examinations. These stones would likely pass unnoticed. Kidney stones are most often found on X-rays or sonograms taken when a patient complains of blood in the urine or sudden pain. Blood and urine tests can help detect any abnormal substance that might promote stone formation.
  • CT scan: If your urology specialist suspects a stone but cannot detect it with a simple X-ray, he or she may use Computed Tomography (CT), an extremely accurate diagnostic tool that can painlessly detect almost all types of kidney stones.

Treatment of Kidney Stones

Your urology specialist may treat your stones with:

  • Shock Wave Lithotripsy (ESWL®): This completely non-invasive procedure is the most frequently used procedure to eliminate kidney stones. It uses a machine called a “lithotripter” that directs ultrasonic, or shock waves, through skin and tissue until they hit the stones. The impact of the repeated shock waves causes the stone(s) to eventually crumble so that they can be easily passed through the urinary tract. This technique is used if the kidney is functioning well and there is no blockage to the passing of the stone fragments.
  • Ureteroscopy (URS): A very small, fiber-optic instrument called an ureteroscope, is used to allow your urology specialist to see the stone by progressing up the ureter via the bladder. Once the stone is seen, a small basket-like device is used to grasp smaller stones and remove them. If a stone is too large to remove in one piece, it can be fragmented into smaller pieces, usually with laser energy. No incisions are necessary and general anesthesia is used to keep you comfortable. Your urology specialist may place a stent within the ureter to allow any swelling to subside.
  • Percutaneous nephrolithotomy (PNL): This is the treatment of choice for large stones when ESWL® or URS are ineffective. While you’re under general anesthesia, your urologist makes a small incision, about one centimeter, between your ribs and hip, and then guides a wire, inserting it into the kidney and then down the ureter. Once a passage is created around the wire, using dilators to provide access into the kidney, a nephroscope is passed into the kidney to visualize the stone. Using an ultrasonic probe or laser, the specialist breaks up the stones and then removes them. The tube is usually left in place overnight to several days to drain the kidney.
  • Open surgery: In extremely rare situations for complicated cases, your urology specialist will recommend open surgery. A large incision will be made to expose the kidney or portion of ureter so that the stone can be removed.

Request an Appointment

If you suspect you have kidney stones, please contact us to make an appointment with the experts at Urological Associates of Iowa City, the best urology clinic in Johnson County.