Kidney Stones in 2013
Thirty years later, I came down with yet another kidney stone. Having experienced one back in ‘84 was enough for me to cringe at the possibilities. However nowadays we have more advanced medications like alpha blockers which can help facilitate passage of small stones. We used Toradol for pain, which is non narcotic. In the process of diagnostics, we used a CT scan, which are easier and quicker to perform and do not require IV contrast. CT scans also provide more information to help with the treatment process. Once the stone was found treatment was decided. We had some options. One of which was ESWL (Extra-corporeal Shock Wave Lithotripsy) which was not available back in 84. This procedure is non invasive.
However for my stone, a urethral stone extraction was done. Today’s instruments are more advanced and much smaller. This helped reduce pain and trauma during the procedure. This was carried out at an out patient facility. After the extraction was performed a stent was placed in. This was a more tolerable experience due to the softness and flexibility of today’s Stents. Additionally, the stent was removed in only 3 days.
All in all, treatment for kidney stones has advanced vastly. From medications to instrumentation we have great options to help you with this problem in an efficient and effective manner.
As both a practicing urologist and a kidney stone patient at New York Urological Associates in Manhattan, I can truly sympathize with and have great empathy for our patients who suffer with kidney stones. The old cliché that passing a kidney stone is worse than childbirth is often used to describe the event. However, not having given birth, I won’t attempt to diminish the discomfort of delivering a baby.The pain is serious though.
I developed my first stone approximately 30 years ago at the age of twenty. This was truly an event I will never forget. At that time (1985) I was a college student and an active athlete. I was hit in my side while playing lacrosse and had lingering pain for several days. I was eventually referred to a urologist after blood was discovered in my urine. At that time CT scans were not yet being used for routine evaluation and I underwent an Intravenous Pyelogram (IVP), now that seems like an ancient test. This test involved infusing a contrast agent into a vein and then taking multiple x rays of the kidneys, ureters and bladder. To my and the urologists surprise, I had a small stone stuck in my left ureter. Treatment for small kidney stones at that time was limited to either trying to pass it, albeit painfully or having a “new” procedure called ureteroscopy. In the mid 80’s there was no medical treatment available nor was shock wave treatment developed yet. Since I was unable to pass the stone , I underwent a ureteroscopy and had it successfully removed. Kidney Stone treatment technology has advanced and now many stones can be treated with non- invasive modalities such medical expulsive therapy (i.e Flomax) or with Extracorporeal Shock wave lithotripsy (ESWL). Some stone types such as those that contain Uric Acid can now be dissolved with medical therapy. My stones, however, are calcium oxalate and not amenable to medical dissolution.
Unfortunately I have had recurrences and more recently had to undergo another ureteroscopy, stone extraction, this time requiring a ureteral stent. (A ureteral stent is a thin tube inserted into the ureter to allow passage of urine from the kidney to the bladder while the ureter heals.) Fortunately , the stent is temporary usually removed after several days. Mine was in for 4 days and was not the most enjoyable time. Going through these experiences has allows me to sympathize with our patients at a different level. I can give them first hand information about what to expect during and after the procedure.
In the event that you, a loved one or friend develops a kidney stone, we at New York Urological Associates truly understand the pain and are here to provide you with expert, compassionate, empathetic and efficient care.