The prevalence of Kidney stones, medically known as Renal stones or Nephrolithiasis, has increased world over.   You too must have encountered one or more persons having stones in kidney. These patients are widely advised in India, about which food they should eat and which food to avoid; Advised about gulping down water to flush out the stones. No doubt, these suggestions prove to be very useful in some cases. But, one should also be aware that some kidney stones can pose great difficulty and discomfort, while passing out through ureters. Like, stones larger than 5 mm in size, staghorn stones, etc.

We attempt to answer few of the most frequently asked questions by the patients about kidney stones:

What age group is commonly involved?

It occurs more commonly in the younger age groups (Males).

What all factors influence stone formation?

• Climate • Occupation • Diet • Water intake

Which is the most common type of stone?

Commonest stone is calcium oxalate, then uric acid and then infection stones.

Calcium Oxalate stones: High oxalate is found in potato chips, peanuts, chocolates, beets and spinach.

Uric Acid stones are associated with gout. More acidic the urine, greater are the chances of these stones being formed.

Infection stones may arise because of recurrent Urinary Tract Infections.

What are the most common presenting complaints?

• Pain in abdomen
• Fever
• Blood in urine
• Repeated block in urine stream
• Difficulty in passing urine
• Sense of incomplete emptying
• Nausea
• Vomiting

However, large stones can be silent.
We, here at Goel Kidney Care, not only offer solutions for stone diseases but also metabolic evaluation of the same. Metabolic evaluation is helpful in cases of diabetics, hypertensives, recurrent stone formation, etc.

What all treatment options are available?
1) Small stones can pass out on their own.
2) Bigger stones – require surgery
• ESWL – Limited indication today  REASON ???

• PCNL- small cut is made on back and the stone is broken before removing

• URS- scope is introduced from the urinary passage in ureter and the stone is removed

• LASER- Holmium (RIRS- Retrograde Intrarenal Surgery )- latest technology. For the first time, in the whole region of Delhi and especially in Punjab, this technology has been introduced.

WHAT IS THE ADVANTAGE OF STONE REMOVAL BY LASER ?
• New technology that saves time
• Provides quality surgery
• Low risk to patient due to less blood loss
• Safe for cardiac and diabetic patients
• No cut required even for kidney stone
• Reduced hospital stay  & Early back to work
• Less chances of stricture formation and scarring
• May become GOLD standard in future

BPH (Benign Prosthetic Hyperplasia or Hypertrophy) pertains to the inflammation of the prostrate gland, found in males. It is the most common fitness problem in ageing men, impacting both the health as well as health-care costs. BPH is not harmful but can be very discomforting. If diagnosed and treated early, it can ease a lot of inconvenience faced by the patients.

An enlarged prostate puts pressure on the urethra that causes most of the symptoms. Urethra is a tube that carries urine from bladder to outside the body.

What are the early Signs and Symptoms?
Thin stream of urine
Sense of incomplete evacuation
Dribbling of urine
Intermittent seam
Hesitancy
Pain and burning during urination
Bleeding
Urine frequency increased especially at night
Urgency
Urine leak

70% of times, the problems can be cured medically. Only in 30% cases surgery is required. There are 3 types of surgery:

– Open: In this a cut is made and the prostate is removed.

– Endoscopy- TURP- In this a scope is put inside from the urinary opening and the prostate is excised. No external cut is made.

– LASER: Thulium Laser (CYBER-TM 150). important To be noted is that according to a study  about 30% of patients are hypertensive, ……% diabetics and ….. have heart problems. LASER therefore comes handy in such cases.