What are Kidney Stones?

Kidney stones (also called renal calculi, nephrolithiasis or urolithiasis) are hard deposits made of
minerals and salts that form inside your kidneys. It can affect any part of your urinary tract —
from your kidneys to your bladder. Often, stones form when the urine becomes concentrated,
allowing minerals to crystallize and stick together.

Signs and Symptoms

● Severe, sharp pain in the side and back, below the ribs
● Pain that radiates to the lower abdomen and groin
● Pain that comes in waves and fluctuates in intensity
● Pain or burning sensation while urinating
● Nausea and vomiting
● Pink, red or brown urine
● Cloudy or foul-smelling urine

How to Prevent
● DRINK enough fluids every day. Eight to twelve cups of fluid per day is enough for most
people.
● AVOID high-purine foods such as red meat, organ meats, and shellfish
● LIMIT sodium (salt) and animal protein such as meat and eggs
● AVOID Alcohol and Smoking

In addition to calcium oxalate stones, another common type of kidney stones is uric acid
stones. Red meat, organ meats, and shellfish have high concentrations of a natural
chemical compound known as purines. "High purine intake leads to a higher production
of uric acid and produces a larger acid load for the kidneys to excrete," said Dr. Jhagroo.
Higher uric acid excretion leads to lower overall urine pH, which means the urine is more
acidic. The high acid concentration of the urine makes it easier for uric acid stones to
form.To prevent uric acid stones, cut down on high-purine foods such as red meat, organ
meats, and shellfish, and follow a healthy diet that contains mostly vegetables and fruits,
whole grains, and low fat dairy products. Limit sugar-sweetened foods and drinks,
especially those that contain high fructose corn syrup.

Drinking more water is the best way to prevent kidney stones. If you don’t drink enough,
your urine output will be low. Low urine output means your urine is more concentrated
and less likely to dissolve urine salts that cause stones.Lemonade and orange juice are
also good options. They both contain citrate, which may prevent stones from forming.Try
to drink around eight glasses of fluids daily, or enough to pass two liters of urine.

You can tell whether you’re hydrated by looking at the color of your urine — it should be
clear or pale yellow. If it’s dark, you need to drink more.
 A high-salt diet increases your risk of calcium kidney stones. According to the Urology
Care Foundation, too much salt in the urine prevents calcium from being reabsorbed
from the urine to the blood. This causes high urine calcium, which may lead to kidney
stones.Eating less salt helps keep urine calcium levels lower. The lower the urine
calcium, the lower the risk of developing kidney stones. Foods high in animal protein are
acidic and may increase urine acid. High urine acid may cause both uric acid and
calcium oxalate kidney stones.

Treatment for Kidney Stones

● Lithotripsy treatment uses shock waves to break up the kidney stone into small pieces.
After the treatment, the small pieces of the kidney stone will pass through your urinary
tract and out through your urine. This treatment usually takes about one hour and may
be done under general anesthesia, which means you will be asleep and unable to feel
the procedure.
● Ureteroscopy - During a ureteroscopy, a doctor inserts a long tube-like tool into your
ureter to take out the stone (if it is small) or break the stone into small pieces (using a
laser if it is large) to pass through your urinary tract and out through your urine.
● Surgery - In rare cases, surgery is needed to remove a kidney stone. During the surgery,
a doctor will insert a tube into your kidney to remove the stone. You will need to be in the
hospital for two to three days to recover from this treatment

Post-op Care for Ureterolithiasis

After undergoing surgery for ureterolithiasis (urinary stones in the ureter), there are certain
post-operative care instructions that you should follow for a smooth recovery.

● Pain Management: You may experience pain or discomfort after the surgery. Your
healthcare provider may prescribe pain medications to help manage the pain. It is
important to take the medications as directed.
● Hydration: Drinking plenty of water is crucial after ureterolithiasis surgery. This helps
to flush out any remaining stone fragments and prevents dehydration. Aim to drink at
least 8-10 glasses of water a day, or as advised by your doctor.
● Activity and Rest: It is important to balance rest and activity during the recovery
period. While it is important to get enough rest, too much bed rest can lead to blood
clots. Gradually increase your activity level as tolerated, but avoid heavy lifting or
strenuous activities for a few weeks, as recommended by your healthcare provider.
● Follow-Up Appointments: Your doctor will schedule follow-up appointments to
monitor your progress and remove any temporary stents or internal catheters if
necessary. Attend these appointments as scheduled and discuss any concerns or
questions you may have.
● Dietary Modifications: Your healthcare provider may advise you to make dietary
changes to promote kidney health and prevent the formation of new stones. This
may include reducing sodium intake, increasing fluid intake, and avoiding certain
foods high in oxalate or calcium. Follow the dietary recommendations provided by
your doctor or a registered dietitian.
These post-operative care instructions may vary depending on the specific surgery you
underwent and your individual circumstances. It is important to consult with your healthcare
provider for personalized instructions and guidance tailored to your situation.

Please note that the information provided is based on general guidelines for post-operative
care for ureterolithiasis. For more specific instructions, it is always best to consult with your
healthcare provider.

References:

6 Easy Ways to Prevent Kidney Stones. (2015, December 24). National Kidney
Foundation;
https://www.kidney.org/atoz/content/kidneystones_prevent#:~:text=To%20prevent%
20uric%20acid%20stones,contain%20high%20fructose%20corn%20syrup.
Boston Scientific. (2023). Www.mykidneystone.com.
https://www.mykidneystone.com/en-US/life-after-surgery/aftercare.html
Kidney Stones: Causes, Symptoms and treatment options. (2021, November 12).
American Kidney Fund.
https://www.kidneyfund.org/all-about-kidneys/other-kidney-problems/kidney-stones
Mayo Clinic. (2022). Kidney stones - Symptoms and causes. Mayo Clinic;
https://www.mayoclinic.org/diseases-conditions/kidney-stones/symptoms-causes/sy
c-20355755