kidney stone recurrence

Does Kidney Stones Recur After Surgery?

Have you recently had a kidney stone surgery or passed it out with the help of medication. Then you need to get yourself updated with all the post-surgery care details. There are some post-surgery complications that can be observed like infection, fever, nausea, slight blood in urine, slower digestion, ureteral stricture, etc. One of the most unwanted post-surgery experiences for any patient is the recurrence of kidney stones after surgery. The recurrence rate of stones after surgery is quite high and it substantially increases if there are some particular underlying health conditions.

Kidney stones are mineral deposits that accumulated and formed toughened stones in the kidneys. The function of the kidney is to filter waste product from the blood and dump it out of the body through urine. When the mineral or salt found in the urine doesn’t dissolve entirely, it crystallizes in the kidney which forms kidney stones. Mostly it is passed through the body safely; however larger stones may build up inside the kidney.

Passing large stones through urine can be a very painful experience and what’s more unfortunate is that it can recur and is not limited to once. There is a high chance of getting kidney stones more than once that is post-surgery or post passing it away. There are studies that show that even getting one stone increases your chances of having another kidney stone greatly. If the people made the required change necessary after the first event then this consequence can be avoided.

Various factors contributing to kidney stone formation

There are various factors that might contribute to kidney stone formation. These factors also determine the type of stone formation. There is a high chance that half of the people who experienced kidney stones once are likely to have them again in the next 5 years. The other risk factor contributing in stone formation is:

• Family history of kidney stones
• High calcium diet
• Obesity
• Urinary tract blockage
• Less fluid intake

There are certain medical conditions that can also increase the risk of developing stones. This is because the low and high level of substances acts as a contributory factor in the formation of kidney stones. These conditions include:

• Diabetes
• Obesity
• Osteoporosis
• High blood pressure
• Hypercalciuria
• Kidney cysts
• Gout and cystic fibrosis
• Parathyroid disease
• Inflammatory bowel
• Surgical procedures 

Certain food can also increase the risk of developing kidney stone. These foods include:

• Sodium Sugar
• Meat and poultry

Types of Kidney stones

There are four main types of kidney stones:

Calcium oxalate: It is the most common type of kidney stone which forms when calcium combines with oxalate. The imbalance in the intake of calcium and fluid intake may act as a contributory factor in the formation of stones.

Uric acid: It is another common type of common kidney stone. Food such as selfish, organ meats has high concentration of natural chemical compound known as purines, which when consumed in high proportion it produces high monosodium urate. It may form kidney stones. This type of stones runs in families.

Struvite: These stones are not very common and are caused by infections in the upper urinary tract.

Cystine: These stones are rare and tend to run in families. Mostly crystals are very small and are easily passed through the body painlessly. However, in some cases, they can build up inside your kidney and form a much larger stone. Some of these larger stones have the chance to even travel to other parts of the urinary tract like the ureter or a bladder.

What are the symptoms of kidney stones?

People can have kidney stones for years but not feel any kind of discomfort. It goes unnoticed until and unless the stone starts to move or become very large, then you may observe symptoms. These symptoms include:

• Pain can be felt in your lower back 
• Nausea or vomiting with pain
• Seeing blood in your urine
• Feeling pain while urinating
• Unable to urinate
• Smelly urine
• Fever and chills

The outlook for a recurrence rate of Kidney stones

Recurrence rates of kidney stones vary from patient to patient. The outlook on the kidney stones is positive; no doubt there is always a risk of recurrence (developing stones again). Most of the stones pass by its own over time, without requiring any treatment. The medical procedures and the surgical treatments are very successful and recovery time is little too.

There is a possibility of getting kidney stones multiple times throughout our life. If you keep developing kidney stones, you need to get proper check-up to draw the result of why it gets happening. Once the cause is found, necessary dietary changes can be made in order to prevent future occurrence of stones.

There is some testing that might give your doctor a grip on the situation as to how kidney stones keep developing. These testing may include

An analysis of the stone composition
A test to evaluate the biochemical evaluation of blood (e.g. uric acid, calcium, creatine, potassium, albumin, bicarbonate)
A urine test (e.g., pH, calcium, volume, Creatinine, oxalate, citrate, uric acid, sodium)

These test acts as a guideline for the initial treatment selection. The analysis of the tests influences greatly on the effectiveness of the treatment.

Prevention of recurrent stone disease

It has been observed that dietary or pharmacological intervention can reduce the risks of recurrent stone disease to a great extent. The nephrologists draft the most suitable and accurate dietary component and pharmacological therapy.

Dietary intervention is designed with the focus on alteration of the concentration of one or more crystal-forming substances in the urine. Increase in the water intake which increases urine volume and lowers the urinary concentration of all the crystal forming substances. Reduction in the dietary oxalate consumption lowers urinary oxalate thus reducing the risk of calcium oxalate stones. Reducing dietary animal protein and other purines leads to lowers urinary uric acid and the risk of uric acid stones.

Increase in the dietary calcium to bind intestinal oxalate which lowers urinary oxalate and the risk of developing calcium oxalate stones. The tailored dietary intervention is based on the metabolic and stone characteristics which are known to impact the recurrence of stones. Pharmacological therapy like thiazide diuretics and citrate therapy also has shown evidence in reducing stone recurrence.
Surgeries for Kidney stones

There are four types of surgeries that are used to treat kidney stones. The three out of which are minimally invasive. The goal of the kidney stone surgery is to treat all the stones at once but many patients need more than one surgery in the reduction or clearance of stones.

Ureteroscopy: This procedure is performed through a small instrument called ureteroscope which is inserted in the urethra through the bladder into a ureter. These instrument retrieves the kidneys stones in a surgical basket and then broken using a laser. These pieces of the kidney stones can now easily exit the body through urinary tract as it is broken into smaller pieces.

Shockwave lithotripsy: In this procedure, the patient is placed in a special type of surgical table or tub. High-energy shockwaves are sent to the stones through the water. These shockwaves break apart the stones which can exit the body easily.

Percutaneous nephrolithotomy: When kidney stones aren’t treatable by other procedures due to various causes –either because the stones are a lot or too large or heavy or because of their tricky location. In this procedure, a tube is inserted directly into the kidney through a small incision in your back. Stones are then broken into pieces by an ultrasound probe and suctioned out so the patient is not required to pass it out. A urethral stent is placed after the procedure which is removed in a week and the patient is typically kept overnight for observation.

Open stone surgery: A long cut is used during this surgery. It is rarely performed as compared to minimally invasive procedures.

The conclusion is the majority of patients with recurrence of kidney stone disease are overweight, hyperuricemia, hyperlipidemia, and hyperglycemia which without a doubt takes our attention towards the role metabolic disorders play in stone recurrence. If you are observing any symptom that indicates kidney stones or you have experienced the complexity of passing stones earlier –then a proper checkup and testing might save you from developing it again.

Satyadev super specialty hospital is a specialized kidney and stone clinic with top-notch technologies. Whether you need surgery or dietary intervention, it’s always a good idea to go for an experienced urologist like Dr. Kumar Rajesh Ranjan. He is leading the Satyadev super speciality hospital with a well-trained team. You will receive proper supervision with all the possible lifestyle changes that can positively alter your life for good.