If your doctor suspects you have a kidney stone, you may have diagnostic tests and procedures, such as:
Blood tests may reveal too much calcium or uric acid in your blood. Blood test results help monitor the health of your kidneys and may lead your doctor to check for other medical conditions.
Tests of your urine, such as the 24-hour urine collection, may show that you're excreting too many stone-forming minerals or too few stone-preventing substances.
Imaging tests may show kidney stones 1in your urinary tract. Options range from simple abdominal X-rays, which can miss small kidney stones, to high-speed computerized tomography (CT) that may reveal even tiny stones. Other imaging options include an ultrasound, a noninvasive test, and intravenous pyelography, which involves injecting dye into your arm vein and taking X-rays as the dye travels through your kidneys and bladder.
Analysis of passed stones
You may be asked to urinate through a strainer to catch stones that you pass. Lab analysis will reveal the makeup of your kidney stones. Your doctor uses this information to determine what's causing your kidney stones and to form a plan to prevent more kidney stones.
The treatment procedures for Kidney Stone include:
Shock Wave Lithotripsy (SWL)
Shock wave lithotripsy (SWL) uses high-frequency sound waves from an external source (outside the body) to break a kidney stone into small pieces, and allow it to pass through the urinary tract.
Ureteroscopy is where a long thin rigid telescope is introduced into the upper urinary tract via the bladder (see diagram below). The diameter of the instrument is less than 2mm and allows visualization of the lower half of the ureter. A small instrument port allows the introduction of micro-baskets and laser fibers (0.3mm in diameter) to manipulate and fragment stones. It is used only to treat stones in the ureter, and cannot treat stones within the kidney.
Pyeloscopy is where a thin fiber-optic telescope is introduced into the kidney from the bladder via the urethra (see diagram). The diameter of the instrument is less than 3mm and allows visualization of the entire kidney drainage system due to the flexible nature of the scope. It contains a small instrument port which allows the introduction of laser fibers (0.3 mm diameter) to efficiently fragment stones, and micro-baskets (less than 1mm wide) to retrieve stone fragments. Kidney stones up to 2 cm in size can be treated using this approach.
Percutaneous Nephrolithotomy (PCNL)
Percutaneous Nephrolithotomy (PCNL) is the preferred technique for treating large stones (over 2cm in diameter) within the kidney. It involves keyhole surgery performed through a 1cm incision in the skin overlying the kidney.
Urinary Tract "Double J" Stent
A thin, hollow tube placed inside the ureter during surgery to ensure drainage of urine from the kidney into the bladder. J shaped curls are present at both ends to hold the tube in place and prevent migration, hence the description "Double J stent".
Robotic or laparoscopic surgery
This procedure is typically reserved for large stones in kidneys that are not in their normal position. Robotic surgery is also highly effective at treating stones in kidneys that are affected by other conditions, such as ureteropelvic junction (UPJ) obstruction, which is a blockage of the kidney where the ureter connects to the hollow portion of the kidney. Robotic surgery is performed with four small incisions through which the robotic instruments are placed.