KIDNEY STONES

When a kidney stone moves tries to move out of a kidney and travels down the ureter to the bladder, several things happen. The first is pain, which can range from mild (rare) to severe (more common). Pain typically is located in the middle or lower back area and may move to the side or lower abdomen.

The stone may cause a blockage to the flow of urine which results in kidney swelling that can lead to permanent kidney damage. There may be blood in your urine. Many patients experience nausea and vomiting. You could develop a urine infection which causes a fever.  If the pain is too intense, or if nausea and vomiting prevent you from drinking liquids, then you may need to go to a local hospital emergency department.

How do you diagnose a kidney stone?

There are a variety of methods to diagnose a kidney stone. Basic testing includes a physical examination, an ultrasound to help locate a stone or area of blockage and a urine analysis to look for blood or an infection. A CT scan or other x-rays that maybe needed to help find a stone.

What can you do if you develop a kidney stone?

Drinking extra liquids to help to flush the stone out and using pain medication, are two of the most effective and time-tested methods available. If the pain is too intense, or if nausea and vomiting prevent you from drinking liquids, then you may need to go to a local hospital emergency department.

Most small stones will pass spontaneously. Larger stones, or ones with rough, jagged edges, may become lodged in the ureter. If that happens, it may be necessary to have surgery. This is usually done through a very thin telescope that is inserted under anesthesia. The telescope is passed up the ureter to locate the stone. Then, using a laser probe, the stone can be fragmented and removed. A small piece of plastic tubing may be left in the ureter to allow it to heal. It can be removed 1 to 2 weeks later. Some ureteral stones, and most kidney stones, can be fragmented with shock waves. The fragments will then pass out in the urine over the next several weeks.

Does diet/nutrition help prevent kidney stones?

Perhaps the most important part of stone treatment is to determine why a stone develops. While most stones are made of calcium, there are many other substances and reasons for stone formation. Dr. Pugach, Medical Director of Pacific Coast Urology Medical Center, provides thorough, painless testing to determine why a stone develops so that he can recommend changes in you diet or medications to help you prevent making more stones in the future. In fact, we offer the services of a certified nutritional counselor to work with our kidney stone patients.

Dr. Pugach and PCUMC's certified clinical nutritionist recommend one basic step to help prevent the reoccurrence of kidney stones: drink more water! Try to drink 12 full glasses of water a day. It has been demonstrated that drinking adequate amounts of water helps to flush away the substances that form stones in the kidneys.  Also, we recommend that you limit your coffee, tea, and cola to 1 or 2 cups a day because the caffeine may cause you to lose fluid too quickly.  Further recommendations may include:

• Cutting back on certain foods. For example, if you have a uric acid stone we may recommend that you limit your meat because meat breaks down to make uric acid.
• If you form oxalate stones (calcium), we may recommend that you limit foods hight in oxalate; such as, spinach, beets, and chocolate.

This is another example of the comprehensive approach we take to ensure your urologic health – now and in the future!  Contact us for more information on our nutritional counseling services.

Patient Testimonial

April 2011

When I experienced my first bout with kidney stones, I had no idea what was wrong, the pain was overwhelming and I kept passing out and waking up on the floor. I finally ended up in the ER, who referred me back to my family doctor. However, I did not have a great experience with the first urologist I was referred to, which was very unfortunate. This doctor could not see on my test results that I had a huge stone that was descending, so he gave me samples of Flomax for my symptoms, scheduled me for a regular follow up in two weeks and sent me home.

That weekend, I had two separate attacks of excruciating pain each sending me to the ER. This time, a different ER physician suggested I follow up with Dr. Pugach.  Dr. Pugach's staff worked me into his schedule immediately, where he quickly assessed my situation and I was scheduled for a procedure soon thereafter to get rid of my existing and very painful stones. Also, I have a very sensitive system with little tolerance for prescription pain medication, so he really got me back on the road to recovery as quickly as possible.

Like most people, I have experienced high pain levels from injuries over the years, but I had never experienced the intense level of pain created by kidney stones. I was beside myself and quite fearful of the situation repeating over and over. But, Dr. Pugach had a better idea - to go forward thinking positively and make some changes for a better outcome.

He also introduced me to a terrific nutritionist who visited me at my home to assess my situation and made wonderful recommendations on how to adjust my food intake and also started me on more meaningful vitamins and supplements. I could feel the different almost immediately, because with the changes I became more energized and balanced. I have become a "water baby" and view my new appreciation of water and proper nutrients as part of my personal arsenal to avoid developing new stones.

As a patient predisposed to generating stones. I am still seeing Dr. Pugach regularly. I have learned to love water and a healthier lifestyle. My test results continue to come back as excellent, and if I ever need help with stones in the future, I know that Dr. Pugach and his staff will be there to help me. Kidney stones are far from fun, but the fear and anxiety of having them come back (if they do) is lessened from knowing that I have the best of the best to help me with Dr. Pugach and his staff.    Catherine, Long Beach
 

To read more patient testimonials, click here.

If you have a question about a service or procedure, please email us or call our office at (888) 735-4336.