urologist

What is a kidney stone?
stone forms in the kidney when there is an imbalance between certain urinary components -chemicals such as calcium, oxalate and phosphate - that promote crystallization and others that inhibit it.
What happens under normal conditions?
The urinary tract, or system, consists of the kidneys, ureters, bladder and urethra. The kidneys are two bean-shaped organs below the ribs in the back of the torso (area between ribs and hips). They are responsible for maintaining balance by removing extra water and wastes from the blood and converting it to urine. The kidneys keep a stable balance of salts and other substances in the blood. They also produce hormones that build strong bones and help form red blood cells. Urine is carried by narrow muscular tubes, the ureters, from the kidneys to the bladder, a triangular-shaped reservoir in the lower abdomen. Like a balloon, the bladder's walls stretch and expand to store urine and then flatten when urine is emptied through the urethra to outside the body.
Most common stones contain calcium in combination with oxalate and/or phosphate.
A less common type of stone is caused by infection in the urinary tract. This type of stone is called a struvite or infection stone. Much less common are the pure uric acid stones. Much rarer is the hereditary type of stones called cystine stones. Even more rare are those linked to hereditary disorders.
Who forms kidney stones?
For unknown reasons, the number of people in the United States with kidney stones has been increasing over the past 20 years. Caucasians are more prone to develop kidney stones than African Americans. Although stones occur more frequently in men, the number of women who get them has been increasing over the past 10 years, causing the ratio to change. Kidney stones strike most typically between the ages of 20 and 40. If a person forms a stone, there is a 50 percent chance they will develop another stone.
What causes a stone to form?
Scientists do not always know what makes stones form. While certain foods may promote stones in susceptible people, researchers do not believe that eating a specific item will cause stones in people who are not vulnerable. Yet they are confident that factors — such as a family or personal history of kidney stones and other urinary infections or diseases — have a definite connection to this problem. Climate and water intake may also play a role in stone formation.
Stones can also form because of obstruction to urinary passage like in prostate enlargement or stricture disease. Stone formation has also been linked to hyperparathyroidism, an endocrine disorder that results in more calcium in your urine. Susceptibility can also be raised if you are among the 70 percent of people with rare hereditary disorders such as cystinuria or primary hyperoxaluria who develop kidney stones because of excesses of the amino acid, cystine or the oxalate in your urine.

DAY CARE P.C.N.L.

The patient gets admitted on the same day morning at 7:00 am
Then the spinal anaesthesia is given during which patient remains fully conscious only two lower limbs are paralysed for about one hour.
The surgery can be watched by the patient and relative on the monitor. Then patient is shifted from or in about average 55-60 minutes.
Then patient is mobilised and made ambulatory with catheter and starts taking orally in next 2 hours.
Same patient takes more of liquids and semisolid diet.
The nephrostomy tube is removed in 4 hours then the per urethral catheter is removed after 8 hours.
There is only 1 c.m. scar on the back after whole surgery.

DAY CARE U.R.S.:

The patient gets admitted on the same day morning at 7:00 am
Then the spinal anaesthesia is given during which patient remains fully conscious only two lower limbs are paralysed for about 60 minutes
The surgery can be watched by the patient and relative on the monitor. Then patient is shifted from operation theatre in about average 55-60 minutes.
Then patient is mobilised and made ambulatory and starts taking orally in next 2 hours.
Patient takes more of liquids and semisolid diet.
PERCUTANEOUS CYSTOLITHOPEXY
SUPRAPUBIC PERCUTANEOUS CYSTOLITHOPEXY
LAPAROSCOPIC URETEROLITHOTOMY.
LAPAROSCOPIC NEPHRECTOMY (NON-FUNCTIING KIDNEY)

Making the Right Nutritional Choices

There are a number of nutritional choices that you can make as part of a kidney stone diet. These include:

Drink a lot of fluids. To keep kidneys clean and functioning properly, frequent urination can help filter out substances. The only way to achieve a higher percentage of urination is to drink a lot of fluids. And the drink of choice for a kidney stone diet is water.

Adding plenty of water to your body on a daily basis will help reduce high levels of calcium that your kidney will have to filter. As part of a kidney stone diet, the recommended daily dose of water is approximately 2.5 liters of water. Those that drink this much and more water per day have experienced nearly a 40% decrease in their chances of developing a kidney stone versus those who drank less.

People who have or previously experienced calcium, cystine or uric acid kidney must consume a minimum of between eight and ten glasses of fluids regularly throughout the day and night. To fulfill this amount would mean having a glass with each meal as well as through the evening hours. All you have to do is take a look at your urine to see if you are drinking enough fluids each day. You know you have had enough to drink if it appears pale and almost watery. If it is dark and yellow, it could indicate that you may need to take in more fluids.

There are specific situations with a kidney stone diet where the fluid intake must be increased from the aforementioned recommended amount. These include people who stay physically active, live in warm climates, and/or suffer from exertion and stress.

And it is not only about the quantity of water in a kidney stone diet; it also involves the quality as well. Compared to bottled water, which is softer, tap water tends to be hard - also depending on where you live - and has a much higher level of calcium. People who drink mineral water as part of their kidney stone diet - despite these having calcium and magnesium - have the ability of possibility reducing their risk for calcium and uric acid kidney stones.
To raise citrate levels in the urine, a protector against calcium stones, a half cup of pure lemon juice taken daily is recommended as part of a kidney stone diet versus orange juice which, although it raises citrate levels as well, also increase oxalate levels and does not lower calcium quantities.

Avoid carbonated beverages. Eat food rich in fiber. Found in ingredients, such as rye, wheat, barley and rice, insoluble fiber is known to have phytate, a compound that seems to halt the formation of calcium salt crystals. To learn more about how diet plans, vitamin consumption, fluid and fiber intake make a dramatic difference on changing your body’s susceptibility to kidney stones, read a feature article on kidney stones diet.