Testing for Kidney Stones
Kidney stones can run in families. Along with an initial physical exam, your health history can help us with a diagnosis. Additional testing may be needed.
Urine Collection and Analysis
After an initial appointment, you will use a urine collection kit to capture your urine over a 24-hour period. The kit can be returned to a lab using pre-paid postage. Results help your urologist determine the cause of your kidney stones. The most common treatment recommendation is often dietary changes. Your provider may also recommend medications or procedures to help prevent future occurrences.
Blood Tests
Blood may be drawn to check for certain levels of calcium or hormones that could cause the formation of kidney stones.
3D Kidney X-Ray
Digital tomosynthesis is a special technology that uses a series of 2D X-rays in a single scan to build a 3D image. The enhanced detail requires only low doses of radiation and allows your urologist to clearly see kidney stones as small as 5 millimeters. This is particularly useful if you have recurrent kidney stones. Low-dose CT scans may also be used to help diagnose kidney stones.
Treatment for Kidney Stones
Kidney stones don’t always require surgery. We work closely with you to minimize their impact and educate you about preventative options. Small, pain-free kidney stones may be passed naturally with help from dietary changes, medication, and guidance from your urologist. Larger, complex kidney stones may require more advanced intervention and an overnight hospital stay.
Medication
Your urologist may recommend medication If you have recurring kidney stones despite dietary changes. Common medicines include potassium citrate, which can alter the acidity of your urine to prevent stones from forming, and thiazide diuretics, which reduce the amount of calcium your kidneys release into the urine. Lifelong use of medications may be recommended to reduce kidney stone formation.
Shock Wave Lithotripsy
This outpatient procedure can treat kidney stones, depending on their size and location. A water-filled cushion is placed on your back, behind the location of your kidney stone. Shock waves pass through the skin to break the stone into smaller, dust-like pieces that pass out of the kidney in urine. You will be sedated for the length of the therapy, which can take up to 45 minutes.
Ureteroscopy
During this outpatient procedure, your urologist will insert a small scope with a camera on its tip into your ureter or kidney to look for stones. A laser breaks the stones into small pieces, which are captured and removed.
Large Kidney Stone Removal
About half of the stone removals Duke urologists perform each year are considered complex because of the size of the stone, its location, and/or its inability to pass on their own. In these cases, kidney stones can be removed through several small incisions using robotic surgery or laparoscopically. We are one of the highest-volume health systems in the country for removing large kidney stones that are about the size of a marble, or bigger.
Percutaneous Nephrolithotomy (PCNL)
This inpatient surgery is performed under general anesthesia so you won't be awake or experience pain. During the PCNL procedure, your surgeon inserts a tube with a camera at the end through a small incision in your back. With X-ray guidance, your surgeon moves the tube to the location of the kidney stone and uses the camera to view it. A special instrument delivers pulses to break up the kidney stone into smaller pieces, which are then captured and removed. The procedure requires an overnight hospital stay. Because there is a chance for small amounts of bleeding if you exert yourself after the surgery, it's recommended that you do not lift anything over 10 pounds for two weeks. After that, you can return to normal activities.
