FAQ

A. This is not completely understood. The most important contributing factor is dehydration, which is common among working adults. Urine is a solution, and potential stone-forming particles are typically dissolved in your urine. But, when you get dehydrated, your urine is not able to dissolve as many particles, and stone crystals can form. There are a number of other dietary and metabolic factors.

A. The most common stones are made of calcium. Other compounds include struvite, which is associated with infections, and uric acid, which is the same material that produces gout attacks.

A. No. Gallstones are mostly made of cholesterol, which is not found in kidney stones.

A. Dissimilar to the popular belief, the pain is not from the stone itself, but from blockage of urinary flow. This typically occurs when the stone passes from the kidney into the ureter, which is the tube that drains urine from the kidney to the bladder. When the urinary flow is blocked, the urine backs up and stretches the kidney and ureter, which are covered in pain-sensing nerves that respond to stretching forces. This produces the severe pain and nausea often experienced with stones attacks.

A. No. Stones that are in the kidney and are not blocking urine flow are not painful. Unfortunately, a few of these stones can grow reasonably large and damage the kidney without causing symptoms.

A. No. Other common causes include muscle pain, nerve pain, severe urinary tract infections, and even severe constipation. Therefore, the diagnosis of kidney stones often requires tests, including labs and X-rays.

A. Potentially, but not always. Kidneys can temporarily lose some of their function when they are blocked by a stone, but in most cases, your kidney will completely recover after the stone is gone. Provided that you are in good health and have normal kidneys, your kidney can tolerate a little over a month of blockage without suffering any permanent damage. However, large stones, especially those that fill the kidney, or stones that remain untreated after a long time, can cause permanent damage to the kidney, and may lead to kidney loss. This damage often occurs without any symptoms, which is why it is important to see a urologist if you have a stone.

A. While many patients will elect for surgical treatment, many small stones can pass without the need for surgery. In these situations, medications that can help your pain and speed up the passage of your stone are usually given. Large stones, or stones that cause other problems, often require surgical treatment.

A. Yes. While you may have passed the stone and simply not noticed it in your urine, it is important to know that there are times that your pain might completely resolve, even though the stone is still blocking your kidney. It is critical that you follow up with a urologist to prevent these silent stones from permanently injuring your kidney.

A. Yes. There are several situations in which immediate evaluation is recommended, even if your pain is mild. These include:

  • You develop fever or chills.
  • You have only one kidney (born with one kidney or had one removed, for example).
  • You stop making urine.
  • You develop confusion or severe fatigue.
  • You develop severe nausea and vomiting.

A. Yes. Unfortunately, once you form one stone, your risk of future stones is increased. You have approximately a 50% chance of forming another stone within 5 years. There are some strategies to reduce the risk of forming stones, but at present, there is no way to completely eliminate your risk.

A. Diets high in sodium can contribute to kidney stone disease. You should avoid adding table salt. Keep in mind that fast foods, restaurant foods, canned foods, deli meats, even condiments such as soy sauce and ketchup contain high amounts of sodium and should be avoided or consumed in moderation. You should limit sodium intake to 2 to 3 grams or less per day. High amounts of animal protein including red meat, fish, poultry and pork can cause certain types of kidney stones, and consumption should be limited to 1-2 servings, 6-8 ounces per day. You should avoid sugary drinks such as those containing sucrose or fructose. Water is the best fluid to drink and you should aim for 2.5 to 3 liters per day, provided you are not on fluid restriction.

A. Typically no. Although it’s true that most stones are made from calcium, for most people, normal dietary intake of calcium and even normal calcium supplementation will not increase your risk of forming kidney stones. In fact, for many stone formers, normal levels of dietary calcium may help to prevent kidney stones.

A. Like the horns of a stag (deer), these stones get their name from the shape they take as they grow to fill the inside of the kidney. Staghorn stones often form because of repeated urinary tract infections (UTIs) with certain kinds of bacteria. Even though they can grow to a large size, you may have no idea you have them because they cause little or no pain. A staghorn stone can lead to poor kidney function, even without blocking the passage of urine. Most often, staghorn shaped stones are the struvite/infection type of stone.

A. Kidney stones are more common in people who have a family member with kidney stones. Some conditions that cause stones may be inherited. But sometimes kidney stones form in relatives because of similar diet and lifestyle.

A. Yes, but rarely. Kidney stones can cause damage if they cause repeated or serious infection or cause kidney blockage for a long time. Some stones, if left untreated, can cause the kidney to stop working.

A. Diet changes recommended for heart conditions also often help prevent stones. A healthy diet with lots of fresh fruits and vegetables and less animal protein and salt can help avoid stones and other conditions. You can learn more from your health care provider or dietician. Keeping a normal weight can also help avoid diabetes and stones.

A. If a stone in the ureter does not pass in a reasonable time or is causing pain or infection, you will need surgery to remove it.

A. You may get another stone even if you’ve had surgery, changed your diet or are taking medications. However, with the right diet and medical treatment, you can be less likely to get stones over and over again.

A. During treatment, your Urologist may ask you to do another 24-hour urine collection and have your blood work checked to see if your urine test results have improved. Your Urologist will also check to see if you are having any side effects from your medications. If you form stones often, you will need monitoring with X-rays and urine studies to be sure no new stones are forming. Your Urologist will monitor you to make sure your medications and diet changes are working.

A. This is a common misconception shared by many people. There is actually little evidence to suggest that cranberry offers protection from urinary tract infections. But, more importantly, cranberry juices and extracts are associated with a significant increase in the risk for kidney stones! So, if you are a stone former, you should avoid cranberry juice!

A. Grapefruit juice. One glass of grapefruit juice can nearly double your risk of forming a stone. Also, megadoses of vitamin C (like those sold as cold prevention remedies) can lead to a rapid formation of a kidney stone and should be avoided, as well.

A. The decision to perform PCNL is generally based upon stone size. For large, complex stones, PCNL is the standard of care.

A. For exceptionally large stones (greater than 2 cm in size), SWL and ureteroscopy are generally incapable of clearing the stone in a single procedure. In fact, over half a dozen or more of these less-invasive procedures would be required to clear a large stone, which would expose you to a lot of unnecessary risk for a questionable benefit. The American Urologic Association has clear guidelines governing the treatment of large stones, and has identified PCNL as the standard-of-care for large kidney stones.

A. PCNL is capable of providing excellent clearance of almost any stone, though there are limitations. Although most stones can be cleared with a single procedure, the largest and most complex stones may require more than one procedure to completely clear the stone. PCNL often requires a tube or stent for temporary drainage after the procedure, which may be associated with some discomfort. PCNL should not be performed on people taking blood-thinning medication. Because it is more invasive than SWL or ureteroscopy, it requires an overnight stay in the hospital.

A. PCNL is safe and effective in the hands of an experienced stone surgeon and is a procedure associated with high patient satisfaction. However, as PCNL is a more invasive procedure than SWL or ureteroscopy, it has a comparatively higher rate of problems associated with the procedure. Major complications, such as severe bleeding or injury to the kidney and adjacent structures, are relatively uncommon. The most common problems are pain associated with the small incision site, the need for a stent or tube to temporarily provide drainage of the kidney, and blood in the urine.

A. Testosterone is the sex hormone that helps boys become men. This hormone is key during puberty and the development of male physical features. Testosterone levels can affect men’s sex drive, erections, mood, muscle mass and bone density. Testosterone is also needed for men to produce sperm.

A. Some men have low levels of testosterone. This is called hypogonadism, or low-T. Men with low-T may also have problems such as:

  • reduced sex drive
  • less frequent sexual activities
  • fewer and weaker erections
  • less energy
  • depressed mood or irritability
  • less muscle mass and strength
  • more body fat
  • anemia (low iron), and
  • loss of calcium from bone

A. Testosterone replacement therapy (TRT) is approved by the FDA to treat men with hypogonadism (low-T). It most often comes in the form of gels, patches, injections (shots), and pellets placed under your skin.



Glossary


Urologist

A doctor who specializes in the study, diagnosis and treatment of problems of the urinary tract.Bladder The hollow, balloon-shaped organ in which urine is stored before it moves through the urethra.

Kidneys

Two large, bean-shaped structures that remove waste from the blood. Ureters Two thin tubes that carry urine downward from the kidneys to the bladder.

Urethra

In males, this narrow tube carries urine from the bladder to the outside of the body and also serves as the channel through which semen is ejaculated. Extends from the bladder to the tip of the penis. Urinalysis A test of a urine sample that can reveal many problems of the urinary tract and some other body systems.

Urinary tract

The organs that take waste from the blood and carry it out of the body as urine.Urinary tract infection (also known as UTI) An illness caused by harmful bacteria, viruses or yeast growing in the urinary tract.

Hematuria

A condition in which there are red blood cells in the urine.

Ureteroscopy (URS)

A procedure that uses a very small telescope to find and remove a stone in the kidney or ureter. Percutaneous Nephrolithotomy (PCNL) A surgical procedure used to treat large kidney stones.

Catheter

A thin tube that is inserted through the urethra into the bladder to allow urine to drain or for performance of a procedure or test, such as insertion of a substance during a bladder X-ray.

Nephroscope

A rigid telescope used during Percutaneous Nephrolithotomy (PCNL) to remove a stone in the kidney. Digital rectal exam (DRE) Insertion of a gloved, lubricated finger into the rectum to feel the prostate and check for any abnormalities.

Prostate

In men, a walnut-shaped gland that goes around the urethra at the neck of the urinary bladder. The prostate supplies fluid that goes into semen. Prostate-specific antigen (PSA) Also referred to as prostate-specific antigen. A protein made only by the prostate gland. High levels of PSA in the blood may be a sign of prostate cancer.

Semen

Also known as seminal fluid or ejaculate fluid. Thick, whitish fluid produced by glands of the male reproductive system that carries the sperm (reproductive cells) through the penis during ejaculation.

Seminal vesicles

An internal structure in the male located behind the bladder and above the prostate gland. It contributes fluid to semen. Sperm Male reproductive cells made in the testicles.

Testicles

Paired, egg-shaped glands located in a pouch (scrotum) below the penis. They produce sperm and the male hormone testosterone. Transrectal ultrasound (TRUS)
A special ultrasound test in which sound waves are produced by a probe inserted into the rectum. In men, the structures most commonly examined with this test are the prostate, bladder, seminal vesicles and ejaculatory ducts.