Kidney stones (renal calculi)

Renal lithiasis (kidney stones) is a very common condition in urology. It happens at least once in a lifetime to close to 10% of the population. Once formed, stones do not dissolve with fluids, olive oil, or home remedies: this is a myth.

It is a very painful condition that generally starts in the flank, in the upper back, with intense, colicky pain that moves forward toward the groin. Often, the pain is so intense that the patient cannot stay still. It can be accompanied by blood in the urine, burning on urination, chills, and fever. The episode improves when the patient passes the stone or undergoes surgery.

The patient should always seek care, since an untreated stone can lead to severe complications, such as an abscess or loss of the kidney. Additional studies are usually required, unless it is an absolute emergency. The basic tests are a plain abdominal X-ray and a general urine test; a urogram, CT scan, and ultrasound are left to the physician's judgment.

Depending on their size and location, stones either pass on their own or require surgery. The treatment options are:

• Medical management with pain medication
• Ureteroscopy: the ureter and kidney are accessed through the natural urinary tract, with very thin cameras through which small instruments are introduced to fragment and remove the stone
• Percutaneous nephrolithotomy: similar to ureteroscopy, but somewhat more complex, since a direct access to the kidney is created through the skin