How to Prevent Kidney Stone ?


Kidney Stones are hard mineral deposits that form inside your kidneys. They cause severe excruciating pain when they pass through your urinary tract. Urinary calculi (Kidney Stone) are more common in men than in women. They usually occurred more frequently between 30 years to 40 years. Once you have had one stone in the kidney, you are 50% more likely to get another within the next 10 years.

There is no one sure way to prevent kidney stones, especially if you have a family history of the condition. A combination of diet and lifestyle changes as well as some medications may help reduce your risk.

  • Staying hydrated by drinking more water is the best way to prevent kidney stones. If you drink less water, your urine output will be low. Low urine output means your urine is more concentrated, and less likely to dissolve a urine salt that causes stone.
  • Lemonade and orange juice are also good options. They both contain citrate which may prevent kidney stone.
  • Try to drink around eight glasses of fluids daily, or enough to pass 2 litres of urine. If you exercise or sweat a lot, or if you have history of cystine stone, you will need additional fluids.
  • Eat more calcium-rich food.  Low calcium diet may increase your kidney stone risk and risk of osteoporosis. Low-fat milk, low-fat cheese, and low-fat yogurt are all good calcium-rich food.
  • A high salt diet increases your risk of calcium kidney stones. High salts prevent calcium absorption from the urine to the blood. This causes high calcium in urine, which may lead to stone formation. So, you should take a low salt diet to reduce the calcium in the urine.
  • Eat less oxalate-rich foods, a natural compound found in foods that bind with calcium in the urine to form kidney stones. Limiting oxalate-rich foods may help prevent the stone from foods high in oxalate are spinach, chocolate, coffee, beats, peanut, rhubarb, and wheat bran.
  • Eat less animal proteins which are acidic and may increase urine acid. High urine acid causes both uric acid and calcium oxalate kidney stones. Avoid beef, poultry, pork and fish.

Retrograde Intrarenal Surgery (RIRS) is an endoscopic surgery performed to remove renal stones. The procedure is done using a flexible ureteroscope, which is placed through the urethra (the urinary opening) into the bladder and then through the ureter into the kidney (intrarenal area). Through this device, a Laser Fiber (Thullium laser) is used to treat the stones.

How kidney stones are treated with RIRS?

The ureteroscope has a small camera fitted at its end which is used to inspect the kidney stones. A monitor screen present in the surgery room displays the entire anatomy of the patient’s kidney captured by the ureteroscope. Through an ultrasound wave or a laser probe, the stones are crushed into fine powder or pieces. These fine pieces can pass easily through the urination process.

What are the advantages of RIRS over older techniques like PCNL (Key Hole Surgery)?

RIRS is definitely less invasive than older techniques like PCNL, laparoscopic or open surgery as it is completely scarless. Because we enter the kidney passing through normal urinary tract and there is no need to make any cuts on skin or hole into the kidney (as in PCNL), there is lesser risk of severe bleeding, hospital stay is very short (daycare surgery in most cases), there is markedly shorter period of recovery and patient can very soon get back to his normal routine.

What is the advantage of using a high power laser in RIRS?

The best outcome for patients can be given with the use of High power laser. Stone clearance in patients with kidney stones up to 4 cm (staghorn stones) can also be possible only with a high power Thullium laser.

Is a stent required to be placed after RIRS? Is it a permanent stent?

Yes, like any other kidney stone surgery, a double J stent is placed in the ureter in most cases of RIRS. The purpose of Double J stent is to keep the ureter open while the laser fragments of stone are washed out and it also decreases the risk of ureteric stricture formation after any intervention. No, Double J stent is only kept temporarily for 2 to 4 weeks and then removed through urethra endoscopically which is a short procedure and the patient can go home the same day after getting it removed.

Can RIRS be used to treat other diseases apart from kidney stones?

Yes, RIRS can be used to treat blockages in the ureter (Strictures/PUJ obstruction), Ureteric and collecting system tumors (for diagnosis as well as treatment).

RIRS is the future of stone surgery. It does require a reasonable amount of experience to master the technique of RIRS but it is immensely beneficial to the patient.

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