Stones form in the urinary tract. When these stones travel down the ureter, there is obstruction, back pressure and pain. The pain is usually severe enough to visit the Emergency Department where a CT Scan allows visualization of the stone, its size and location and if there are other stones waiting travel down the ureter in the future.
Fortunately, most small ureteral stones pass spontaneously without any intervention. The small 1-2 mm stones can be the most painful and these are the stones which pass with the highest frequency. If a ureteral stone does not pass, there are ways we can help this process.
Extracorporeal Shock Wave Lithotripsy (ESWL) involves generating shock waves outside the body and focusing the shock waves on the stone. General anesthesia is required. The good news is this is a very effective way to break the stone up into very small pieces of sand like material which can then pass down the ureter, into the bladder, and out the urethra. This procedure is very safe, the risk being one of the pieces of the stone may not be small enough to easily pass by itself. A small percentage has to be treated again or undergo a ureteroscopy to remove the fragment.
Sometimes, if a ureteral stone is very dense and impacted in the ureter, we need to perform ureteroscopy and use a laser or basket to totally remove the stone.
There are basically five kinds of stones, the majority of which are calcium oxylate containing stones. We like to collect the stone/fragments and send these for analysis. If you are a “stone former”, we perform a metabolic evaluation which includes blood tests for calcium, kidney function, etc. We also like to have you submit a 24 hour urine collection of urine for analysis of stone forming ingredients: calcium, oxylate, citric acid, uric acid and others. We then can advise our patient how to minimize further formation of stones. Some suggestions generic to all stone formers are: increase water intake, fruits and vegetables. Avoid added salt and take calcium citrate supplementation with each meal.
To make an appointment with Dr. Golden, in Spokane Valley, submit the contact form on this page, or call us at (509) 921-0099 today!