To determine the presence, location, size, and composition of your urinary stones, your urologist may conduct lab or imaging tests. Once the presence of stones has been confirmed, an analysis of your passed stones may be done to form a suitable prevention plan.
Blood testing
Blood tests can detect high levels of calcium or uric acid, indicating the presence of urinary stones. Results also help evaluate the function of your kidneys, which may prompt further investigations.
Urine testing
A urine sample is analysed to detect blood and stone-forming minerals. The presence of white blood cells and bacteria in the urine suggests you may have UTI.
Computed tomography (CT) scans
CT scans use a mix of X-rays and computer technology to produce images of your urinary tract. They reveal the size and location of a urinary stone, whether it is obstructing the urinary tract, and conditions that may have caused the stone to form.
Ultrasound
Ultrasound is a non-invasive test that uses sound waves to create a picture of your kidneys and bladder. This method can identify uric acid and other non-calcific stones if they are large enough.
Abdominal X-ray
Abdominal X-rays can show the location of stones in the urinary tract but are less frequently used because some stones will not be visible.
You may be requested to urinate through a strainer to collect any passed stones. By analysing the stones, your urologist can identify their composition and utilise this data to determine the underlying cause of your kidney stones. This will help to avoid future occurrences.
Consult a urologist for a personalised management plan.
During ESWL, shock waves are generated outside the body and focused on the kidney stones to break them down into smaller pieces, which can be passed out of the body through urine. First, your urologist will use an ultrasound or X-ray to locate the urinary stone. Once the stone is located, a machine will generate the shock waves and they will be delivered to the stone through a device placed against the skin.
Shockwave treatment for kidney stones is done on a day surgery basis and usually takes 50-70 minutes to complete. After the treatment, you may experience some pain or discomfort in the back or side where the stone is located, and there may be some blood in your urine. However, most patients are able to return to their daily activities within a few days.
ESWL works better with some stones than others and is more appropriate for certain people as X-rays and shock waves are used. Your urologist may recommend other types of kidney stone treatment if any of the following apply to you:
During ureteroscopy, a thin viewing tube (ureteroscope) with a lens and light is inserted through the urethra and gently advanced to the bladder or ureter. Once the stone is located, your urologist will address it in one of two ways depending on its size:
Ureteroscopy is usually performed under general anaesthesia, so you will not feel any pain or discomfort during the procedure.
If there are no complications, you can typically go home the same day. After the procedure, you may experience some discomfort or pain, and there may be some blood in your urine. Your urologist will give you instructions on how to manage any discomfort or pain. Most people can return to their daily activities within a few days after the procedure.
It is recommended that you consult a urologist for a thorough assessment.
RIRS is similar to ureteroscopy in that it also involves inserting a ureteroscope through the urethra to the bladder under general anaesthesia. The main difference is that RIRS is more commonly used for stones located in the kidney. Once the scope is moved through the ureter to the kidney and the stone is seen, it can be fragmented by laser and extracted with small forceps or baskets.
RIRS is done as a day procedure or with an overnight stay depending on the nature of the kidney stone. Once discharged, you may be advised to rest for a few days and avoid any strenuous activities for a week or so after the procedure. Pain medication may also be prescribed to manage any discomfort.
PCNL is a procedure done under anaesthesia where a tiny incision is made in the side of the back for a small tube (nephroscope) to be inserted directly into the kidney to locate and remove the stones. For larger kidney stones, a device like a laser is required to fragment the stones into smaller pieces before removal.
After the procedure, you will likely need to stay in the hospital for a few days for observation and pain management. A catheter (nephrostomy tube) may be used to help drain urine from the kidney. Recovery time can vary depending on the size and complexity of the stone and the individual patient's overall health.
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