What I Need to Know
about Kidney Stones

Are all kidney stones alike?

No. There are four major types of kidney stones.

• The most common type of stone contains calcium (KAL-see-um). Calcium is a normal part of a healthy diet.
  
• Calcium that is not used by the bones and muscles goes to the kidneys. In most people, the kidneys flush out the extra calcium with the rest of the urine. People who have calcium stones keep the calcium in their kidneys.
  The calcium that stays behind joins with other waste products to form a stone.
  
• A struvite (STROO-vite) stone may form after an infection in the urinary system. These stones contain the mineral magnesium (mag-NEE-zee-um) and the waste product ammonia (uh-MOH-nyuh).
  
• A uric (YOOR-ik) acid stone may form when there is too much acid in the urine. If you tend to form uric acid stones, you may need to cut back on the amount of meat you eat.
  
• Cystine (SIS-teen) stones are rare. Cystine is one of the building blocks that make up muscles, nerves, and other parts of the body. Cystine can build up in the urine to form a stone. The disease that causes cystine stones runs in families.
  

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What do kidney stones look like?

Kidney stones may be as small as a grain of sand or as large as a pearl. Some stones are even as big as golf balls. Stones may be smooth or jagged. They are usually yellow or brown.

Golf-ball-sized and brown	Small and smooth	Jagged and yellow
Kidney stones vary in size and shape. These are not actual size.

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What can my doctor do about a problem stone?

If you have a stone that will not pass by itself, your doctor may need to take steps to get rid of it. In the past, the only way to remove a problem stone was through surgery.

Now, doctors have new ways to remove problem stones. The following sections describe a few of these methods.

Shock Waves

Your doctor can use a machine to send shock waves directly to the kidney stone. The shock waves break a large stone into small stones that will pass through your urinary system with your urine.

Two types of shock wave machines exist. With one machine, you sit in a tub of water. With the other type of machine, you lie on a table.

The full name for this method is extracorporeal (EKS-truh-kor-POR-ee-ul) shockwave lithotripsy (LITH-oh-TRIP-see). Doctors often call it ESWL for short. Lithotripsy is a Greek word that means stone crushing.

Tunnel Surgery

In this method, the doctor makes a small cut into the patient's back and makes a narrow tunnel through the skin to the stone inside the kidney. With a special instrument that goes through the tunnel, the doctor can find the stone and remove it. The technical name for this method is percutaneous (PER-kyoo-TAY-nee-us) nephrolithotomy (NEF-roh-lih-THAH-tuh-mee).

Ureteroscope

A ureteroscope (yoo-REE-ter-uh-scope) looks like a long wire. The doctor inserts it into the patient's urethra, passes it up through the bladder, and directs it to the ureter where the stone is located. The ureteroscope has a camera that allows the doctor to see the stone. A cage is used to catch the stone and pull it out, or the doctor may destroy it with a device inserted through the ureteroscope.

Ask your doctor which method is right for you.

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How will my doctor find out what kind of stone I have?

Try to catch a stone in a strainer.

The best way for your doctor to find out what kind of stone you have is to test the stone itself. If you know that you are passing a stone, try to catch it in a strainer.

Your doctor may ask for a urine sample or take blood to find out what is causing your stones. You may need to collect your urine for a 24-hour period. These tests will help your doctor find ways for you to avoid stones in the future.

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Why do I need to know the kind of stone?

The therapy your doctor gives you depends on the type of stone you have. For example, a medicine that helps prevent calcium stones will not work if you have a struvite stone. The diet changes that help prevent uric acid stones may have no effect on calcium stones. Therefore, careful analysis of the stone will help guide your treatment.

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