Question: I have had kidney stones for years and pass small stones. I have had lithotripsy in past. Should I go ahead and lithotrip the large ones?
Dr. Hibberd's Answer:
Stones (or calculi in medical lingo) can form in the urinary tract for various reasons that include heredity, medications, dietary excesses, and underlying medical conditions that tend to cause crystal formation and urinary sediment deposits.
Many stones are small and will pass (painfully) from the kidney through the same passageways urine follows until they are either passed or get stuck on the way out.
We often advise that a stone analysis be performed so we can customize a treatment regimen that will minimize recurrent stone formation. Many stones have spicules that catch on tissue and do not just "roll" out freely. Urinary tract obstruction from stones is usually temporary, but some need to be retrieved or even blasted (by ultrasonic procedure called lithotripsy) if not passed within three to four days.
The presence of stones in your kidney suggests they may have already grown too large to pass spontaneously, and will simply grow in size until removed, or obstruct your kidney, or become infected. You could end up needing a larger open procedure to save both your life and your kidney.
Having larger kidney stones removed is usually wise, then follow a treatment regimen that will discourage their return. Differing stones have differing recommendations, so be sure to get your stones analyzed so your treatment can be customized.
As to lithotripsy, this is not a trip in the park either, but has been revolutionary for those whose stones are not retrievable by other means. Some stones will continue growing into large staghorn (literally huge horned rocks in the kidney that often interfere with renal function and jeopardize lives when left in) calculi. Fortunately, these are uncommon today with the advent of retrieval techniques and lithotripsy.
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