Kidney Health

Treating Kidney Stones

Summary & Participants

How your kidney stones are treated will depend on the size, location and type of stone you have. Our panel of experts will discuss the different options, and how you and your doctor can decide which one is right for you.

Medically Reviewed On: June 19, 2008

Webcast Transcript

JON MARKS, MD: There are a number of different machines, but in general, the machine that we are illustrating here, there is a spark plug that sits at the bottom. It sits within a reflector. The shocks that are generated are focused at a point well above the reflector. If you bring a patient's body on top of that reflector apparatus in such a way that the stone corresponds to where the shocks are focusing, all the energy created by that spark plug discharge is focused on the stone, doing minimal damage to the surrounding tissue.

PAUL MONIZ: What does the patient feel?

JON MARKS, MD: Well, it is uncomfortable for the patient, and uncomfortable enough so that they require some sort of sedation in order to be able to tolerate the experience. There are other machines that can be used that require no sedation, but they are much less effective.

PAUL MONIZ: After the procedure is done, what happens to the stone? I assume that it breaks up. How quickly does it pass out of the system?

JON MARKS, MD: In general, and this depends on the composition and the size of the stone, but if the stone is well fragmented such that the fragments are two and three millimeters, a little bit larger than grains of sand or the size of very small BBs, these stones will gradually pass out of the patient, sometimes within the first few days, but sometimes it will take up to three months for the fragments to pass.

PAUL MONIZ: We have some shots of what those broken up pieces look like. Maybe Dr. Salant can walk us through that. Now if someone had a fairly large stone, this is just a couple of fragments or three fragments that might come out. They may have a whole bunch of them, is that right?

ROBERT SALANT, MD: Yes. After the procedure is done patients will pass several stone fragments. Literally, it could be hundreds depending on how large the initial stone was and how small the fragments had been broken into.

In general, we usually have the patients strain the urine so when the stones do come out you're able to save the fragments which can then be analyzed to see what type of stone was in the body.

PAUL MONIZ: So they have this procedure. It's about 35 minutes. Then they start passing the stones. How painful is it to pass conceivably hundreds of stones?

ROBERT SALANT, MD: Stones cause pain only under two circumstances. One, if there is active infection, and two, if the stones are causing blockage to the urine flow. If the procedure is successful the stone fragments are small enough that they should pass without causing blockage and therefore without significant amounts of pain. There may be some discomfort, but in general after a successful procedure, there should be minimal if any pain.

PAUL MONIZ: Is there a lot of blood after the procedure in terms of the urine?

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