DR. MATTHEW S. LEE
Kidney Stone Frequently Asked Questions
Kidney stones are common and estimated to affect at least 10% of the American Population. For a first-time kidney stone former, there's about a 50% risk that you may have another kidney stone in the following 10 years.
Disclaimer: the following information is general advice only and should not replace advice your personal physician has given you as each patient and clinical situation is unique.
1)
What kind of surgical options are there for kidney stone removal?
In general, shockwave lithotripsy, ureteroscopy, and percutaneous nephrolithotomy are the three main surgical treatments for kidney stones. In most cases, these surgeries are all done with the patient completely asleep i.e. general anesthesia. Shockwave lithotripsy is a completely non-invasive surgery that uses shockwave energy to break up stones from outside the body. Ureteroscopy is when the surgeon inserts a small camera through the urethra up to the kidney or the ureter to identify the stone and use a laser to break up the stone. Percutaneous Nephrolithotomy is where the surgeon makes a small incision on the skin and places a working tube directly into the kidney to break up the stone. It is typically the best surgery for larger stones.
Shockwave lithotripsy and ureteroscopy are good options for stones that are less than 2 cm in size. Typically, ureteroscopy may be slightly more painful than shockwave lithotripsy, but offers a higher chance of successfully removing the stone than shockwave lithotripsy. For stones that are larger than 2 cm in size (or larger than 1 cm in the lower part of the kidney), Percutaneous nephrolithotomy typically offers the best chance of successful kidney stone removal. Dr. Lee will go over further details about each of these options with you during your initial visit.
2)
What is a ureteral stent?
A ureteral stent is a small rubber tube that is usually temporarily left in the kidney to allow the kidney to drain well. This helps the kidney heal and prevents any postoperative blockage. Dr. Lee usually leaves your stent on a string so that you can remove it yourself 3-5 days after your surgery. Stents can cause urinary urgency, frequency, and some groin and flank pain
3)
What kind of pain medications will I be given after ureteroscopy surgery?
Urologists have found that prescribing opioids are ureteroscopy is not necessary. Our typical non-opioid pain control cocktail includes Acetaminophen (Tylenol) 1000mg every 6 hours, Diclofenac 50mg every 8 hours, Tamsulosin (flomax) 0.4mg every night, and pyridium 200mg every 8 hours. This cocktail usually manages postoperative pain quite well and doesn't carry any risk of addiction, constipation or overdose.
4)
I've read that dark chocolate, nuts, and spinach can increase your risk of stones. Is that true?
For recurrent stone formers or patients who are interested in stone prevention, Dr. Lee will send pieces of your stone during surgery to the lab for analysis. Furthermore, he will have you complete a one or two 24 hour urine collections (Litholink tests). This test is very helpful in stone prevention as it gives your doctor very detailed information on your urinary chemistry and if there are any modifiable factors that can be adjusted to reduce your future stone risk.
In general, stone prevention tips include:
a) Drink plenty of water. Your goal should be 80-100 oz of water per day if you've formed stones before. To be more accurate, you should drink enough to produce 70 oz of urine per day, which sometimes could be more than 100 oz of fluid per day (depending on how physical your job is)
b) Maintain a low salt diet. Your goal should be less than 2300 mg of sodium per day. It may seem unrelated, but eating too much salt will increase your urine calcium levels and increase your stone risk
c) Eat a well balanced diet. I.e. eat plenty of fruits, vegetables and moderate your animal protein intake (eating too much chicken, pork, fish, or red meat can increase your risk of stones).
d) During your consultation with Dr. Lee, he may review other stone prevention tips, but for the best personalized prevention tips, Dr. Lee will need your stone analysis and 24 hour urine results
