Kidney Stones

Kidney stones are a common urban disease and are prevalent in Hong Kong, particularly among men aged 30 to 50 years old. The causes of kidney stones include genetic factors, inadequate water intake, excessive consumption of salt, sugar, or food high in oxalate such as strong tea, chocolate, nuts, or spinach. Common types of kidney stones include calcium oxalate stones, calcium phosphate stones, and uric acid stones.

When kidney stones are small, they may not cause any symptoms. However, as the stones grow or descend from the kidneys into the ureters, they can cause obstruction, leading to severe pain in the lower back, nausea, and vomiting. The movement of stones within the urinary tract can also cause scrapes and result in hematuria (blood in urine) or even symptoms such as fever and chills.

Doctors will arrange computed-tomography scans (CT) to accurately assess the condition of the stones and conduct blood and urine tests to evaluate kidney function and the acidity or inflammation of the urinary tract.

The treatment of kidney stones depends on their size and location. If the stones are

larger than 5 millimeters, extracorporeal shock wave lithotripsy (ESWL) can be used to break them into smaller pieces by transmitting shock waves through the skin. This procedure has a success rate of 70-80% for stones measuring 1 centimeter or less.

When kidney stones drop into the ureters, ureteroscopy with laser lithotripsy (URSL) can be performed. The urologist inserts a ureteroscope through the urethra into the ureter and uses laser energy to break the stones. The success rate of this surgery can reach 90%.

For kidney stones larger than 2 centimeters, percutaneous nephrolithotomy (PCNL) can be considered. Under the guidance of X-ray or ultrasound, the doctor punctures the skin with a needle to access the kidney and then creates a channel through which a nephroscope is inserted to break and remove the stones. This procedure has a stone clearance rate of over 90%

(URSL procedure)

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