Early treatment of kidney stones in women is crucial to prevent damage of the kidneys and deterioration of the renal functions. The lines of treatment include pharmaceutical agents, surgical therapy and lifestyle changes.
Diet modification is the first management step in almost every woman with kidney stones. Every woman with kidney stones should increase her fluid intake to increase her 24 hour urinary output. In most cases, drinking of about 2-3 liters of water can increase the urinary output to a reasonable level. Not only increasing the daily fluid intake can prevent the formation of more stones, but it can also help expel already formed stones along with the voided urine. In the past, most physicians used to recommend decreasing the consumption of foods with high levels of calcium salts. However, this has lately proven to be a wrong strategy as excessive dietetic calcium restriction can increase the incidence of calcium oxalate stone formation. Women with proven oxalate kidney stones are usually advised to limit the consumption of oxalate containing foods such as spinach, rhubarb, chocolate and beets.
Pharmaceutical agents are used to treat kidney stones. Analgesics are used to treat the pain that usually accompanies movement of the stones down the urinary tract from the kidneys. Renal colic from stones is considered one of the severest types of pain a woman can encounter in her whole life. Strong analgesics, such as morphine, are usually administered when the pain is so intense. Allopurinol is a drug that decreases the production of uric acid and is very useful in women with uric acid stones.
Surgical treatment is the mainstay of treatment of kidney stones in women who develop severe pain, obstruction and/or infection. Most cases that are indicated to receive surgical management for their stones are usually treated with noninvasive techniques, while conventional surgical stone removal is nowadays limited to a small percentage of atypical cases. Extracorporeal shockwave lithotripsy or ESWL is usually the best line of treatment for women with stones less than 2 cm in diameter. The technique involves production of electromagnetic or electrohydraulic waves which are focused on the stones leading to fragmentation, thus facilitating their expulsion with the voided urine.
Endoscope guided surgical removal of the stones is one of the most commonly used minimally invasive procedures to treat kidney stones in women. An endoscope that is introduced into the lower urinary tract is used to facilitate removal of the stones under direct vision. The procedure is highly effective in removal of the stones when used by skilled medical personnel.
Although open surgical techniques are seldom used to treat renal stones, they are sometimes the sole line of management. Removal of the stones from the kidney is achieved through a skin incision. This technique is often used after failure of ESWL and/or endoscopic minimally invasive techniques.
The lines of treatment for kidney stones in women are numerous. When early detection and treatment are implemented, the outcome of renal stones in women is almost always favorable. Careful clinical and laboratory investigation of every case is the cornerstone of picking up the right treatment plan that should eradicate kidney stones in women.
