Tips of Kidney and Ureteral stones


This section is information for foreign patients.

We introduce some information about kidney and ureteral stones.

 

ESWL will be performed under intravenous sedation strongly in Funabashi clinic. Therefore, you need to stay in clinic while 1 or 2 night.

 

 

 

  • Stones aren't usually painful while they are still in your kidneys.
  • When stones leave your kidney, they travel to the bladder through the ureter. Some stones are tiny and pass through without causing symptoms.

 

  • When stones block the flow of urine out of the kidney, it can cause the kidney to swell (Hydronephrosis), often causing a lot of pain.
  • Common symptoms of kidney stones are:

         ★  Pain in the lower back, side, or groin. 

         ★  Hematuria

         ★  Nausea, vomiting.

         ★  Infection:fever and chills.

Kidney Stones: A Patient Guide

from Urology Care FoundationTM The Official Foundation of the American Urological Association

 

  • Whether stones will pass on, it depends on its size.
  • 80 to 90% of stones are calcium stones that arenot dissolved by medications. Only 4 to 6% of stones, such as “cystine and Uric acid stone”, are dissolved by medications. Moreover, Dissolving therapy takes long-term.
  • For stones that likely not pass naturally, we will recommend treatment procedures below. See the chapter “Treatment”.

Diagnosis


 

 

 ★ X-Ray is important in differentiating between radiolucent and radiopaque  

     stones and for comparison during follow-up.

    Radiolucent stones can't be performed ESWL.

 

 

★Ultrasound should be used as the primary diagnostic imaging tool.

 

★CT scan has become the standard for diagnosing acute flank pain.

 It can determine stone diameter, density and radiolucent stones on X-ray.

 When stones are absent,the cause of abdominal pain should be identified.

 

★ Patients with kidney stones need a succinct biochemical work-up of urine and blood test.

Treatment of renal colic


For Pain : Non-steroidal anti-inflammatory drugs (ex.ロキソニン®︎,ボルタレン®︎) are the first choice. If you have severe pain, antispasmodic/spamolytic drug (ex.チアトン®︎, セスデン®︎ ) are also available.

 

For Nausea : (ex プリンペラン®︎, ナウゼリン®︎)

 

For lower ureteral stones, Medical expulsive therapy:

α1-blockers(ex.ハルナール®︎) may accelerate the passage of urinary stones by relaxing smooth muscle

without preventing peristalsis. However it can prescribe only for elderly male in Japan.

 

Herbal medicine(ex.チョレイトウ®︎ ウロカルン®) might accelerate the passage of urinary stones.

 

 Treatment


 

 These treatments help remove kidney stones, using one or more of these strategies:

 

①  Wait for stones to pass by themselves

 

②  Breaking up stones by ultrasonography so that smaller pieces can pass  

  (this procedure is called “ESWL”)

 

③  Removing stones through the ureter by ureteroscopy (this procedure is called “TUL”)

 

④  Holding the ureter open using a temporary tube called a stent,

  then stone fragments pass more easily (this procedure is called “ ureteral stents”)

 

⑤  Removing stones from kidney (this procedure is called “PCNL”)

 

  • ESWL will be performed under intravenous sedation strongly in Funabashi clinic. Therefore, you need to stay in clinic while 1 or 2 night.

 

Kidney Stones: A Patient Guide

from Urology Care FoundationTM The Official Foundation of the American Urological Association

 

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