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Ques : Can I take something to dissolve my kidney stone?

Ans : Patients often ask whether something can be taken to dissolve their stones. Unfortunately, the most common stone types (calcium oxalate and calcium phosphate, accounting for 80% of all stones) cannot be dissolved with medications.

However, in patients with uric acid stones, which account for 5-7% of stones, medication (potassium citrate) can be successfully given to dissolve the stones, helping them to pass and          preventing them from re-developing.

Patients with the even less common cystine stones (1-3% of stone formers) can also benefit from potassium citrate and water intake to help dissolve their stones. Cystine stone formers additionally can be treated with D-penicillamine or α-mercaptopropionylglycine to help bind and dissolve their stones.

Ques : What is Extracorporeal shock wave lithotripsy?     

Ans :Extracorporeal Shock Wave Lithotripsy (ESWL) is the most common treatment for kidney stones. Shock waves from outside the body are targeted at the kidney stone causing the stone to fragment. The stones are broken into tiny pieces and pass out of body through urine.

Ques : When can ESWL be used?

Ans : ESWL works better with some stones than others. Very large stones cannot be treated this way. The size and shape of stone, where it is lodged in your urinary tract, your health, and your kidneys' health will be part of the decision to use it. Stones that are smaller than 2 cm are the best for ESWL. The treatment might not be effective in very large ones.

ESWL is more appropriate for some people than others. Because x-rays and shock waves are needed in ESWL, pregnant women with stones are not treated this way. People with bleeding disorders, uncontrolled infections, severe skeletal abnormalities, or who are morbidly obese also not usually good candidates for ESWL. lf your kidneys have other abnormalities, your doctor may decide you should have a different treatment. lf you have a cardiac pacemaker, a cardiologist will decide if you can have ESWL.

Ques : Does the patient need to be hospitalized?

Ans : Not usually. In most cases, lithotripsy is done on an outpatient basis.

Ques : What are the advantages and disadvantages of this treatment?

Ans : The main advantage of this treatment is that it treats kidney stones without an incision. As a result, hospital stay and recovery time are reduced.

But occasionally the stone may not break adequately and a repeat procedure (or a different procedure) is needed.

Ques : What can the patient expect after treatment?

Ans : The recovery time is usually fairly brief. After treatment, the patient can get up to walk almost at once. Many people can fully resume daily activities within a day. Special diets are not required, but drinking plenty of water helps the stone fragments pass. For few days, you may pass stone fragments.

Ques : What will happen after I leave the hospital?

Ans : After treatment, you may have blood in your urine. Other people may experience cramping pain in the stomach as shattered stone fragments make their way out of the body. Oral pain medication and drinking lots of water will help relieve symptoms.

Call your doctor if you feel the strong need to urinate even after you empty your bladder or if you are in extreme pain even when taking your pain medicine.

Ques : What other treatment choices for kidney stones are available?

Ans : Drug treatment is being studied with such drugs as such as calcium channel blockers (nifedipine), steroids and alpha-adrenergic blockers. Other drugs such as K-citrate, thiazides or allopurinol are prescribed to prevent new stones from developing. Most doctors agree that more medical trials are needed.

When ESWL is not appropriate or doesn't work, some people will need ureteroscopy, a technique that goes through the bladder to reach the stone or percutaneous nephrolithotomy a technique that goes through a small incision created in your back. Some people, in extremely rare cases, even need open surgery, a technique that involves a larger incision in your abdomen. The medical terms for kidney stone surgery (with an incision) are ureterolithotomy or nephrolithotomy.