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Kidney stones or ureter stones often do not cause any complaints, but can also be extremely painful. If the urinary discharge from the kidney is prevented by a stone, the kidney is put under stress and this can cause the typical 'renal colic'. In this case, severe pain can be observed in the kidney area. If the stone has already descended into the ureter, this can also cause lower pain complaints (even up to the testes) as well as the feeling of frequent urination without being able to urinate effectively.


Conservative stone treatment


Most kidney stones can be passed out spontaneously. Depending on its size and location, this can take up to a few weeks (eg for smaller stones in the ureter, there is a 95% chance that you will pass it within 6 weeks).


Possibilities are:
1) Medical expulsion therapy: with the help of medication we try to dilate the ureter, so that the stone can pass easily.

2) Chemolysis: if we know that you are producing uric acid stones, for example, an attempt can be made to dissolve these with the help of medication.


Active stone treatment


If your kidney stone is too large, causes too many complaints despite pain relief or there are signs of infection, an active stone treatment will be chosen.

Depending on various factors and taking into account your preferences, you can choose:


1) ESWL (Extracorporeal Shockwave Lithotripsy): or 'kidney stone crushing', in which ultrasonic shock waves through a balloon can cause a fracture line at the level of the stone and shatter it. The procedure takes place via the day hospital, where you will receive a sedation via the anesthetist, but you will therefore not be completely anesthetized before administering the shock waves. The days after the procedure you may urinate out pieces of stone gravel, but you may see a limited amount of blood when you urinate. Sometimes several sessions are necessary if there is a very large or hard stone.


2) Ureteroscopy: in this procedure, where you are placed under a general anesthetic, we go with a camera through the bladder to the stone in the ureter or kidney. The stone is then removed in its entirety or shattered using the laser. At the end of the procedure, a stent is sometimes left behind, this is an internal tube between the bladder and kidney that allows the ureter to heal nicely. This is then removed again after a few days to weeks under local anesthesia.


In rare cases, your ureter may naturally turn out to be very narrow, making it unsafe to maneuver the camera up to the kidney. In that case, a stent will also be left to gradually widen the ureter. Some time later (on average 2 weeks) the effective stone treatment can then take place in a second time.


3) Percutaneous kidney stone removal: Larger kidney stones (> 1.5cm - 2cm) are preferably removed via keyhole surgery via the back. A camera is inserted into the kidney via a small incision on the back to crush the stone into pieces and remove it in the same way. Sometimes it is necessary to have a nephrostomy at the end of the procedure, which is a drainage tube that allows urine to drain directly from the kidney through the back. This is usually removed after 1 or more days.



Stone prevention


The most important thing to prevent new stone formation is to drink enough. It is nevertheless recommended to drink at least 2 to 2.5L of water per day. It is also important to eat a varied diet and exercise enough.


If you form stones at a young age or form stones regularly, the urologist may request a stone analysis. Depending on what kind of stone it is, additional advice can be given in connection with any dietary measures or medication.

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