For the treatment of kidney stones there are many ways, such as: medication and surgical treatment, specific to each person applicable methods, need to be based on the condition to choose, kidney stones is one of the most common diseases in urology.

Kidney stones are the result of an abnormal accumulation of some crystalline substances (e.g. calcium, oxalic acid, uric acid, demineralized acid, etc.) and organic matrix systems (e.g. matrix A, acidic mucopolysaccharides, etc.) in the kidneys.

Clinical manifestations of kidney stones

Symptoms of kidney stones depend on the size and shape of the stone, where it is located and the presence of infection and obstruction. Most people with kidney stones are asymptomatic unless the stone falls from the kidney into the ureter causing a blockage of urine in the ureter. Common symptoms at this time include lower back and abdominal cramps, nausea, vomiting, irritability, bloating, and hematuria. If combined with a urinary tract infection, chills and fever may also occur. The pain associated with acute renal colic is often more severe and unbearable.

Treatment of Kidney Stones

First of all, symptomatic treatment should be used, such as pain-relieving drugs when colic attack, if found to be combined with infection or obstruction, the infection should be controlled first according to the specific situation, and ureteral intubation or pyelostomy should be carried out if necessary, to ensure that the urine drainage is smooth, to control the infection, and to prevent the damage of renal function. At the same time, actively search for the cause of the disease, according to the different components and etiology of the development of treatment and prevention programs, from the root of the problem, try to prevent the recurrence of stones.

1. General treatment:Drinking large amounts of water, smaller stones are discharged by flushing with large amounts of urine, and the increase in urine also helps in infection control. For urinary stones caused by pathologic factors, the original disease should also be actively treated. Actively treat the cause of stone formation to prevent stone formation and recurrence.

2. Medication:M-type cholinergic receptor blockers, which relax ureteral smooth muscle and relieve spasm. Nifedipine, a calcium ion blocker, is effective in relieving renal colic; alpha receptor blockers are effective in relieving spasm of ureteral smooth muscle and treating renal colic. Antibiotics should be used to control or prevent urinary tract infections.

3. Surgical treatment:Surgical measures should be considered when pain is not relieved by medication or when the stone diameter is large. These include: ① Extracorporeal shock wave lithotripsy (ESWL) treatment. ② Intraureteral stenting, which can also be combined with ESWL treatment. ③Transureteroscopic lithotripsy and lithotripsy. ④ Percutaneous nephrolithotomy. ⑤Laparoscopic incision lithotripsy.

Summarized version: stones smaller than 7mm are possible, stones smaller than 4mm have a better chance of success.

Kidney stones, in layman's terms, are "stones" growing inside the kidneys. Although kidney stone is a benign disease, sometimes it may be stuck in the path of discharge, blocking the urine discharge, triggering renal colic, hydronephrosis, and long time and serious can lead to impaired renal function, or even uremia.

For kidney stones or urinary stones, the exact treatment will depend on the symptoms as well as the size and location of the stones.

Asymptomatic, especially stones less than 5 mm in diameter, are not operated on.

Larger stones, proximal ureteral stones, surgery.

Presence of painful, obstructive or infected guano stones, surgery.

Dr. Chen Zhou

Clinical first-line physicians in nephrology

M.S. in Nephrology

Affiliation: Department of Nephrology, Changhai Hospital, Second Military Medical University, China

Dedicated to: FFSGS, kidney stones, high uric acid kidney injury and other diseases diagnosis and treatment research and kidney health popularization work.

Feel free to leave a comment with questions related to kidney stones!

Kidney stones are a disease that seems painless but may cause a lot of pain to the patient. Stone stones, as the name suggests, are stones that appear inside the kidneys, and since they are something that shouldn't grow, they certainly won't do any good.

Very small stones may have no symptoms, but if the stones gradually increase in size over time, they may cause problems to the patients. And when the stone is discharged, it may get stuck halfway, causing difficulty in urination, and even can cause renal colic, hydronephrosis, etc. A long and serious period of time can lead to destruction of renal tissues, impaired renal function, and even uremia.

How to treat kidney stones, the choice of method has a lot to do with the size of the stone. For stones that are very small, in a location that is relatively easy to dislodge, and usually have no symptoms, especially those with a diameter of less than 5mm, conservative treatment is usually taken, drinking plenty of water and urinating diligently, maintaining a healthy lifestyle, and surgery is not the first thing to be considered.

For larger stones, which are more difficult to pass on their own, extracorporeal lithotripsy can be considered to pulverize the larger stones into smaller ones to help pass them. And for stones that show significant symptoms, cause pain, or are in the proximal ureter, causing obstruction and infection, surgery needs to be considered.

Due to the complexity and variability of kidney stones, the nature, shape, size and location of the stones are different, and are affected by a variety of factors such as individual differences in the patient, therefore, the treatment of kidney stones is often also the use of individualized comprehensive treatment measures. The following is to talk to you about the treatment of kidney stones in various cases:

For primary kidney stones <10mm with no obstruction in the lower urinary tract, a diet + medication approach is taken, starting with the stone composition.

First of all, the kidney stone composition is determined by stone composition analyzer: infrared spectroscopy to determine the stone composition, and then targeted treatment, for example:

• Patients with pure uric acid stones are treated with alkalinization of the urine with sodium potassium hydrogen citrate and sodium bicarbonate, oral allopurinol and dietary modifications that avoid high-purine foods.
• In patients with cystine stones, the urine is alkalized with sodium hydrogen potassium citrate, sodium bicarbonate, and large fluid intake, and treated with oral a mercaptopropionylglycine and acetylcysteine. During and after stone removal, a sodium- and cystine-rich protein-restricted diet is applied.

• Infected stones require infection control, oral ammonium chloride to acidify the urine, and application of urease inhibitors.
• In patients with calcium phosphate stones, the application of aluminum hydroxide gel to limit intestinal absorption of phosphate has the effect of preventing stone formation. During and after stone removal, the intake of phosphate-rich foods such as seafood and beans should be minimized to reduce stone formation.
• For calcium oxalate stones, alkalize the urine with potassium sodium citrate, sodium bicarbonate, and take oral vitamin B6 and magnesium oxide. During and after stone removal, it is advisable to eat less food that contains oxalic acid strong tea, spinach, tomatoes, bamboo shoots, wild rice, strawberries, plums, and all kinds of dried fruits.

In addition, all urinary tract stone medication requires drinking large amounts of water, maintaining a daily urine output of more than 2,000 ml, and drinking additional water at night before bedtime. And all should pay attention to limit sodium <5g, do not use monosodium glutamate. And the addition of antispasmodic and analgesic drugs and traditional Chinese medicine, in order to promote the discharge of kidney stones, and reduce the process of kidney stone discharge, the pain caused by the patient. For the stones in the lower calyces of the kidney, the inverted position should be used if necessary to facilitate the discharge of the stones.

For primary kidney stones >10 mm, the following treatments are appropriate.

• 1、Extracorporeal shock wave lithotripsy (ESWL): It is suitable for kidney stones <2cm in diameter and upper urinary tract stones, after lithotripsy, combined with the composition of the stones, plus the above food + medicine treatment. If ESW treatment is needed again, the interval should be more than 10-14 days, and the number of ESWL treatments is usually not more than 3-5 times. The lithotripsy treatment method is forbidden in the following cases: urinary tract obstruction distal to the stone, pregnancy, bleeding disorders, severe cardiovascular and cerebrovascular diseases, aortic or renal aneurysms, uncontrolled urinary tract infections, etc., excessive obesity, high renal position, severe deformities of bones and joints, and unclear localization of stones, etc., which are unsuitable to use this method due to technical reasons.

• 2、Percutaneous nephrolithotripsy and lithotripsy (PCNL): It is suitable for all kidney stones that need surgery except for those who have coagulation mechanism disorders, are too obese for the puncture needle to reach the kidney, or those who have spinal deformities, as well as some of the larger upper ureteral stones above L4.
• 3, Ureteral flexible scopes are mainly used for the treatment of kidney stones <2cm.
• 4, the need for open surgical treatment of kidney stones: ① for the renal pelvis ureter obstruction combined with renal pelvic stone patients, can be treated with pelvic incision lithotripsy; ② for the stone in the renal pole or the stone is located in the calyx of the kidney has obvious dilatation, parenchymal atrophy and obvious recurrence factors of the patient, to take partial nephrectomy; ③ due to the stone caused by the renal structure of the severe destruction, loss of function or combined with the renal pus, and the opposite side of the renal function of patients with good, using nephrectomy treatment , are treated with nephrectomy.

• 5, special circumstances of the treatment of kidney stones: ① one side of the kidney stones, the other side of the ureteral stones, the ureteral stones first. ② bilateral renal calculi, under the premise of preserving the kidney as far as possible, first deal with the side that is easy to take out and safe, if the renal function is poor, severe obstruction, poor general condition, it is appropriate to first percutaneous nephrostomy, to be improved when the patient's condition and then deal with the stone; ③ isolated renal upper urinary tract stone caused by acute complete obstruction of anuria, timely surgery, if the condition can not tolerate surgery, the first to be placed in a ureteral catheter through the stone drainage, if even the catheter can not pass the stone, then the transureteral catheter, the first to be placed in the ureteral catheter. If even the catheter is unable to pass the stone, a percutaneous nephrostomy is performed, and the patient's condition improves before choosing the appropriate treatment.

For secondary kidney stones caused by other diseases, the primary disease is treated. For example:

• In patients with hyperparathyroidism and urinary stones due to a parathyroid adenoma, stone formation can be prevented only by removing the parathyroid adenoma.
• The presence of mechanical obstructive disorders such as stenosis of the renal pelvic-ureteral junction, renal ureteral malformations, calyceal diverticula and horseshoe kidneys, and intra-renal type of stenosis of the renal pelvis and calyceal necks should be relieved of the obstruction as early as possible in order to prevent the formation of renal calculi.

Urinary stones, which may also be referred to as urolithiasis, is a general term for kidney stones, ureteral stones, bladder stones, and urethral stones, and is one of the very common urological disorders.

Clinically, a fairly complete and effective stone prevention and treatment system has been formed, specifically for the prevention and treatment of kidney stones, there are two main purposes, one is to prevent the recurrence of stones, and the other is to remove the stones and protect kidney function.

In fact, the rate of self-excretion of kidney stones is high; therefore, the possibility of self-excretion of stones should be considered first before making decisions on various treatment options. The self-excretion rate of kidney stones is about 50% for 5 mm stones, only 20% for ≥6 mm stones, and rarely for ≥10 mm. Ureteral stones that remain in the urinary tract for more than 4 weeks will adversely affect renal function, and those that remain for more than 6 weeks are very difficult to expel.

The main treatments for kidney stones that are difficult to remove on their own are as follows.

I. Extracorporeal Shock Wave Lithotripsy (ESWL) With the application of modern minimally invasive techniques, extracorporeal shock wave lithotripsy has become the first line choice for kidney stone treatment. The size and composition of stones are the main parameters and indications for the development of treatment programs. Extracorporeal Shock Wave Lithotripsy (ESWL) is preferred when the stone diameter is <2cm.

Second, percutaneous nephrolithotripsy lithotripsy (PCNL) This technique is preferred when the stone diameter is ≥2cm, dehiscence-shaped stones, and multiple renal stones.

Third, the traditional open surgical treatment At present, the rate of open lithotripsy has been greatly reduced, accounting for only 1%-5% of the total surgical treatment, when the stone volume is too large or too many, by SWL or PCNL treatment failure, etc., can consider surgical lithotripsy.

Fourth, if the composition of kidney stones is uric acid stones, stone dissolution treatment can be performed.

Fifth, dietary therapy, such as drinking a lot of water is a simple and effective way to prevent and treat kidney stones. And it is now recognized that drinking a lot of water helps to prevent the recurrence of stones, and the daily water intake standard is to keep the daily urine volume above 2000ml.

In addition to adjust the dietary structure according to the composition of the stones, high-calcium component of the person to reduce the intake of calcium-containing foods, less milk, dairy products, soy products, etc.; oxalic acid stones in the diet should limit the intake of oxalic acid, oxalic acid-rich foods, including spinach, strong tea, tomatoes, chocolate, etc.; high uric acid patients should also be taken to a low-purine diet, mainly to avoid overconsumption of foods such as animal offal.

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How do you treat kidney stones?

When it comes to kidney stones, many people may have had this disease and are familiar with it. The pain in the kidneys, hematuria, nausea and vomiting at the onset of the disease are still fresh in the minds of many people. Some people may have a certain understanding of the symptoms of kidney stones, but not many people know how to treat, today I will share the knowledge of kidney stone treatment.

1. Treatment of the cause:

Since the kidney stones, that the body is the existence of some factors of stone formation, if the cause of the treatment can be very good results; such as some people repeatedly get kidney stones because the body has a parathyroid adenoma, this disease can cause hyperparathyroidism, which caused by the body of the elevated blood calcium, thus increasing the risk of kidney stones, if you do not remove the tumor, it will always be repeated to get kidney stones;

2. Stone diameter <0.6cm can be considered as medication for lithotripsy:

Patients with kidney stones with a diameter of <0.6cm and smooth stones and no obstruction in the urinary tract below the kidney can consider medication; medication is mainly used for pure uric acid stones and cystine stones; for uric acid stones, oral allopurinol can be used, while for acetylcysteine stones, propionylglycine can be used; in addition, infected stones need to be controlled by infections, and then oral ammonium chloride can be used to acidify the urine;

3. Ultrasonic lithotripsy can be used if the diameter of kidney stone is ≤2cm:

Ultrasonic lithotripsy is mainly applicable to stones with a diameter of ≤2cm, it tends to have a better therapeutic effect and is not traumatizing, but not all people are suitable for this treatment; ultrasonic lithotripsy should be contraindicated in cases where there is obstruction in the urinary tract below the stone or in cases of pregnancy;

4. Percutaneous nephrolithotripsy can be used if the stone diameter is ≥2cm:

This approach is mainly suitable for relatively large stones, mainly in the ultrasound localization, in the lumbar back with a fine needle puncture to the kidneys, and then in the nephroscope to remove or crushed stone; but like blood clotting abnormality, too obese or spinal deformity of the patient is not suitable to use this way of treatment of kidney stones.

Final Summary: The treatment of kidney stones depends mainly on the diameter of the stone, as described above, and will not be repeated here.

The above is my answer to the question, purely hand-typed, it is not easy, if you feel that the writing can be rewarded with a praise, if you have any questions you can leave a message below ......

Due to the complexity and variability of urolithiasis, the nature, shape, size and location of the stones are different, the localization of the urinary tract varies, and individual patient differences, the choice of treatment and the expected efficacy of the treatment method is very different, some of them only drink more water to expel the stones on their own, while some of them have to use open surgery may not be able to take all the stones. Therefore.The treatment of urolithiasis must be patient-individualized and sometimes requires a combination of treatments.

Generally, if the stone is <15px, smooth, without urinary tract obstruction, without infection, pure uric acid stone and cystine stone, conservative treatment can be used first. For stones <10px in diameter and smooth, 90% of them can be expelled on their own.

There are many factors that influence the formation of urinary tract stones.The high incidence and recurrence of stones makes appropriate prophylaxis important:

1, drink a lot of water: to increase the volume of urine, dilute the concentration of stone-forming substances in the urine, reduce crystal deposition. It is also conducive to the discharge of stones. In addition to drinking more water during the day, drink water once a night to keep the urine diluted at night, which can reduce the formation of crystals.A 24-hour urine output of 2000 ml or more in adults is an important preventive measure for patients with any type of stone.

2. Adjustment of diet: Adjust the composition of food according to the composition of stones and metabolic state.

(1) People with high calcium intake should reduce the intake of calcium foods;

(2) Patients with oxalate stones should limit their intake of strong tea, spinach and tomatoes;

(3) Patients with high uric acid should avoid high purine foods such as animal offal.

If you have any questions, you can leave them in the comments section and I'll respond when I see them.

The above answer is provided by Ms. Song Mingyue, a registered dietitian of MicroSugar

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When you have kidney stones, don't be nervous, keep a good attitude, listen to your doctor's advice and choose the right treatment according to your condition! A relative I know also went to the hospital some time ago, due to severe back pain, and was examined for kidney stones.

Someone once described the pain of kidney stones this way: "It does not hurt, all things are in harmony with the birth of a quiet good, it hurts, the world collapsed just want to jump off a building." There are also people who say that the degree of pain of kidney stones is second only to women's labor and delivery, so it can be imagined ......

Why do people get kidney stones?

The urinary system includes kidneys, ureters, bladder and urethra, their function is to maintain the stability of the environment within the body, the kidneys process water and some metabolic products produced by the body to generate urine, the ureter is the urine generated by the kidneys transported to the bladder, the bladder to store urine, and when the urine reaches a certain amount of urine to assist in urethra to discharge the urine. After people eat, the body in the metabolism of waste, will produce some of the generation of solid substances, such as: oxalate, urate, phosphate, etc., under normal circumstances, the amount of these substances is small and dispersed, in the urinary system along with the urine out of the body. But by some life, dietary factors, such as: drinking too little water, excessive intake of meat foods, etc., will make the amount of these substances increased, and tightly crowded to the arrangement of the small crystals will be formed, and then with time, and gradually polymerization to form a solid.

According to the size as well as the location of the fructification, the pain is different, in most cases, the kidney stone and the human body are at peace with each other, but sometimes the kidney stone will fall to the ureter, and then fall to the bladder, and then discharged through the urine, but because the ureter is not a smooth and uniform tube, there are wider places, and there are also relatively narrow places, when the fructification falls into the narrow place, plus the fructification is relatively large, then it will certainly be stuck, such a situation leads to the urine can not be smoothly discharged, and the expansion of water retention, triggering the ureter smooth muscle spasm and pain.

Points to note in the daily diet of kidney stone patients:

Daily attention is mainly to assist in preventing the reoccurrence of kidney stones, first of all, daily uniform intake of > 3L of water (except milk and tea) urine volume should be > 2L; in addition to the diet should be low sodium, low purine diet. Eat some high oxalic acid content of vegetables to remember to blanch, avoid excessive fat intake, drink less beer, and remember to eat dinner as early as possible, at least 4 hours away from going to bed at night.

Thanks for inviting to answer the question ''What should I do for kidney stones''?

Kidney stones are formed when urate, calcium, microorganisms, and certain drugs crystallize and roll larger and larger in the kidney. When the stone is less than 0.7Cm, it can flow into the ureter with the ureteral orifice, and when it enters the stenosis, hydronephrosis and renal colic can occur.

Treatment of kidney stones:

(a) First of all, usually pay attention to drink more plain water, can flush the urinary tract, to prevent the concentration of urine crystallization.

(ii) Pay attention to dietary vegetables not to eat spinach, soy products.

(iii) No sulfa drugs to prevent crystallization of drugs to form stones.

(d) for asymptomatic kidney stones, are relatively small, most of them are found during physical examination. For this kind of stone can drink more water, more exercise, eat the stone punch plus chicken gold orally, and add scopolamine 10mg to expand the ureter is conducive to stone removal. Treatment for one month to three months to do ultrasound examination to see the efficacy.

(e) Some kidney stones may enter the ureter and become embedded in the narrow part of the ureter, causing hydronephrosis and renal colic. These patients are admitted to the hospital on an emergency basis for ultrasonic lithotripsy, which has a high cure rate, and anti-inflammatory drugs are used for one week after lithotripsy to prevent infection.

(vi) For larger kidney stones, minimally invasive stone extraction and interventional therapy are feasible when conservative treatment is ineffective!

My answer is for your reference, or you can follow my previous posts that have discussed it!

Kidney stones cause great harm to patients. It is well known, so we should treat it in time. So how to treat kidney stones?

Kidney stones may be persistent and asymptomatic, especially in larger stones, and smaller stones have a wide range of motion. When entering the renal pelvic-ureteral junction or the ureter, it causes violent peristalsis in the ureter to induce stone expulsion, resulting in colic and hematuria. Pain caused by kidney stones can be categorized into dull pain and colicky pain. The pain is usually located in the lower back and abdomen and is mostly paroxysmal or may be persistent. Some pain may manifest as low back pain and discomfort only, and activity or labor can precipitate or worsen the pain.

When the diameter of renal stone is ≥ 8mm, the combination of Chinese and Western medicine and conservative treatment is not effective. When the diameter > 10mm, extracorporeal lithotripsy and surgical removal of the stone are recommended. As stones cause severe urinary tract obstruction, hydronephrosis cannot be relieved for a long time and affects renal function, it should be treated as soon as possible. When the stone is obstructed in the urethra, the pain is severe and there is no urine, at this time, you should make jumping movements and drink a lot of water, which is conducive to the discharge of the stone.

In the case of small stones, medications can be used to remove the stones and are usually available in the form of kidney stone granules and stone purifying capsules. The way to prevent this disease is to drink more water and urinate to promote the excretion of small stones. In addition, eating less spinach, seafood, and timely treatment of urinary tract infections and congenital anomalies are conducive to the prevention and treatment of kidney stones.

Eating plenty of foods rich in vitamin A can maintain the health of the urethra and help avoid the recurrence of stones. These foods include: carrots, broccoli, cantaloupe, papaya, and beef liver, but high doses of vitamin A are toxic and it's best to consult your doctor before taking them. Don't eat too many oxalate-rich foods, including beans, beets, celery, chocolate, grapes, peppers, parsley, spinach, strawberries and tea.

[I hope this answer can help you, have questions please consult our physicians, will be free to answer your questions].