One in ten Americans will be affected by kidney stones at some point in their life and about a million patients will experience a kidney stone attack this year. While most stones will pass on their own, larger stones can be life-threatening. Now there is a new non-invasive treatment that can safely wipe out stones, even in extreme cases.
A sudden slip out of the shower one morning saved Stacy Cassell’s life. “It was by the grace of God that I fell. If I wouldn’t have fallen, we may have never have found them,” kidney stone patient Stacy Cassell, told Ivanhoe.
Back pain from the fall sent her to the emergency room, but doctors found something much more serious, Staghorn kidney stones. Stones so big they nearly filled both kidneys.
“He’s (the doctor) was like if we didn’t find these you could have been dead by the end of the year,” Cassell explained.
Doctor Julio Davalos says our bodies naturally flush out most kidney stones, but once they reach about the size of a raisin they become hard to pass. Stacy’s were so large, surgery was her only option. Doctor Davalos used a new laser called lumenis versapulse on Stacy’s stones. This enabled her to pass the stones on—her—own, lowering her risk of complications.
“This laser technology really helps in that manner in that I’m able to fragment the stone into minute grains of sand and that can just sort of pass out of the kidney and flush out,” Chesapeake Urologist Doctor Julio Davalos, told Ivanhoe.
Since a special type of laser energy setting is used, there’s a better chance that no other tissue is affected saving Stacy’s kidneys and giving her a second chance with her son and dog Kelly.
Stacy’s doctor told her she most likely got the stones because she doesn’t keep herself hydrated.
The lumenis versapulse laser can be used in advanced cases like Stacy’s or to dust smaller stones. The minimally invasive treatment usually requires general anesthesia, but patients can go home the same day.
BACKGROUND: Kidney stones are small, hard deposits that form inside your kidneys. The stones are made of mineral and acid salts. Passing kidney stones can be quite painful, but the stones usually cause no permanent damage. (SOURCE: http://www.mayoclinic.com/health/kidney-stones)
SYMPTOMS: A kidney stone may not cause symptoms until it moves around within your kidney or passes into your ureter. At that point, these signs and symptoms may occur:
· Severe pain in the side and back, below the ribs
· Pain that spreads to the lower abdomen and groin
· Pink, red or brown urine
· Cloudy or foul-smelling urine
MEDICAL BREAKTHROUGH: There are many different types of lasers used in medicine. For kidney stone work, a PowerSuit holmium laser in direct contact with the stone is commonly used. This minimally-invasive treatment usually requires general anesthesia, but you may go home the same day. The doctor uses an endoscope in order to get close to the stone. A small fiber is snaked up the endoscope so that the tip can come in contact with the stone, the intense light energy breaks the stone into increasingly smaller pieces, which can be extracted or flushed out. (SOURCE: http://www.zimbio.com)
Julio Davalos, MD, Medical Director of the Kidney Stone Program at Chesapeake Urology, talks about a new method for treating kidney stones.
Can you talk about kidney stones and how they’re formed?
Dr. Davalos: Kidney stones occur in about one in ten Americans over a lifetime. There’s about a million patients that will experience a kidney stone attack this year. Kidney stones form for a variety of reasons. One of the things that we do at Chesapeake Urology is that we not only do the surgical aspects of treating patients, but also preventative aspects in terms of trying to figure out their stone type and what metabolic disorder may have led to their stone disease. There are about a dozen different reasons that stones can form and most patients, including physicians out there as well, will sort of have a few ideas as to what causes a stone, but there’s really more complexity to it than just being able to say one or two things cause stones. There are obvious things that can cause stones such as dehydration; certain dietary changes, and then certainly there are some things in terms of just how you are born.
What would be some of the treatments that are available right now?
Dr. Davalos: In terms of looking at stones; the majority of stones are not surgical stones. Most stones you can pass on your own—with just some supportive care. Looking at options to actually treat a stone would include things like shockwave lithotripsy, in which a machine is used to locate the stone with x-ray and shock waves are used to break up the stone. Other options would include a scope surgery; where a scope is placed internally to locate the stone and a laser is used to break up the stone. A more invasive procedure would be a small incision surgery going in to the kidney directly or laparoscopic or even open surgery in extreme cases.
When is it necessary to have surgery to remove a stone?
Dr. Davalos: Size matters when it comes to stones. Size is really the big determiner as well as your own anatomy. For the most part a stone that is four millimeters or smaller we say is virtually universally passable. There’s a very small chance that a four millimeter stone or smaller will not pass. But five millimeters you get to the fifty, fifty point where you sort of flip a coin, half of them will pass, half of them won’t. Then every millimeter above five millimeters you start to really get diminishing returns in terms of being able to pass a stone. So stones that are six, seven millimeters and bigger you can certainly consider treatment. Anything that’s above ten millimeters, I always tell my patients, well you may be able to pass a ten millimeter stone and set a record. For the most part we consider anything above ten to be not passable. So it’s really all determined by size.