Kidney Stones: Diagnosis and Treatment

Kidney stones often go unnoticed until severe pain is felt. Sometimes kidney stones are detected while looking for the cause of chronic urinary tract infections. The diagnosis and treatment of kidney stones is simple, but sometimes the only treatment is giving it time to pass.

Diagnosis of Kidney Stones

If the doctor suspects kidney stones, he may order blood work to check for the presence of high levels of calcium or uric acid. He may also ask the patient to collect urine samples for 24 hours to check for too many stone-forming minerals or not enough inhibiting substances.

A computerized tomography(CT)scan is the test commonly used to diagnose kidney stones. It is performed quickly without the use of a contrast dye, and can identify stones no matter what they are made of.

An x-ray of the abdomen is used in the diagnosis of kidney stones. It can show most stones and give the doctor a way to track the changes in size over a period of time.

An ultrasound is used to diagnose larger kidney stones. It uses high-frequency radio waves and computer processing to view inside the body. If stones are small, an ultrasound may miss them.

A diagnostic tool called intravenous pyelography was widely used at one time to diagnose kidney stones. A contrast dye is injected into the arm and a series of x-rays are taken as the dye moves through the body. It can show the doctor where the kidney stones are, how big they are and how much they are blocking the flow of urine.

Treatment for Kidney Stones

Kidney stones that are too large, causing bleeding, or other damage need to be treated by the doctor. One method used in the treatment of large kidney stones is extracorporeal shock wave lithotripsy(ESWL). It is the most commonly used treatment for large stones. It uses shock waves to break the kidney stones apart so it can pass out of the body through the urine.

In some cases surgery is needed to treat kidney stones. There are three surgical methods a doctor can use. The first treatment is percutaneous nephrolithotomy which involves removing the stone through a small incision in the back using an instrument called a nephroscope.

For kidney stones in the ureter, a treatment the doctor uses is ureteroscopic stone removal. An instrument called a ureteroscope is passed into the ureter through the bladder. The kidney stone is snared and removed.

Sometimes kidney stones are produced by an overactive parathyroid gland. These glands are located on the four corners of the thyroid gland just below the Adam's apple. Too much parathyroid hormone is produced usually as the result of a benign tumor on the gland. The surgical treatment used in this instance is parathyroid surgery.

The diagnosis of kidney stones can be done quickly allowing the doctor to make the decision as to what treatment, if any, needs to be done. The most painful part of having stones is trying to get them out.

Mayo Clinic