Kidney stones painful, treatable

LAURIUM – Few ailments look more unassuming than kidney stones, and few are more painful.

They start in the kidney, tiny specks of calcium and oxalate that accrete over months or years.

Many stones lie undetected until they move from the kidney to the ureter, the passageway from the kidney to the urinary tract, where they block urinary flow and dilation.

About 1 in 10 people will eventually get kidney stones, said Shahar Madjar, urologist with Aspirus Keweenaw Hospital in Laurium. Those who develop them have about a 50 percent risk of getting another.

“If you have the genetic predisposition, then it could be a lot of things … your diet, or the fact you don’t drink enough,” he said.

Drinking plenty of water is recommended, he said. Chocolate, tea, nuts and berries can contribute to an elevated likelihood of kidney stones.

“By avoiding all that food, the chance you could have it is less,” he said.

Even among people who do have them, the speed at which stones develop varies, Madjar said.

“In some people they may come very quickly, so I can go remove a stone and then half a year later they’ll have another stone,” he said.

Besides severe amounts of pain, kidney stones can be accompanied by vomiting, fever and chills.

Deciding whether or not to remove a kidney stone depends on where it is, and how big. If a stone won’t pass on its own, several treatment options are available.

In Shockwave Lithotripsy (SWL), shockwaves are applied through the skin without incisions. For larger stones in the kidneys, there’s percutaneous nephrolithotomy. A finger-wide tract is opened in the kidney; once the stone is identified, the stone is broken apart and grasped and removed through the tract. Unlike the other procedures in use, it requires longer hospitalization after the procedure.

Madjar said the most common technique is ureteroscopy. In that process a small instrument with a digital camera at its tip is inserted into the urethra to locate the stones. A small laser fiber is also used to break up the stone into small chunks, which can then be collected by an instrument. About nine of 10 patients who undergo the procedure become stone-free.

Madjar demonstrated the camera Tuesday, directing it back and forth over a book, which was reproduced in color on an adjacent screen.

“We can really see very clearly,” he said.