Kidney Stones
Our kidneys are bean-shaped organs that filter about 37 gallons of blood every day, removing excess water and waste in the form of urine. Sometimes, however, the salts and minerals that kidneys remove can bind together forming hard, sometimes jagged, stones ranging in size from a grain of sand to a golf ball. When these objects are very small, they can pass through the body unnoticed. Larger ones, however, may cause a blockage that prevents urine from passing, leading to severe pain, nausea or blood in the urine. Kidney stones can be caused by not drinking enough water, eating certain foods, consuming too much salt and multiple medical conditions including obesity and diabetes among other things. Kidneys stones can lead to serious health consequences if left untreated.
Orlando Health Medical Group Urology is a team of caring providers who can diagnose and treat kidney stones, often using minimally invasive techniques. Same day kidney stone treatment is offered at some of our locations.
Pain in the back, belly or groin can be key indicators of a kidney stone. The location of the pain can shift based on whether the stone is in the kidney, in the tubes (called ureters) connecting the kidneys to your bladder, or in the urethra, which is how urine ultimately leaves the body. Pain may be dull or sharp.
Other kidney stone symptoms include:
- Burning during urination, or trouble urinating
- Producing only small amounts of urine
- Increase frequency or urgency of urination
- Blood in urine
- Nausea or vomiting
- Fever
Our team of specialists uses minimally invasive techniques to treat kidney stones. In addition to removing these painful stones from the kidney, ureter and bladder, our dedicated team determines the cause of kidney stone development and works with the patient to prevent further episodes. Procedures include:
- Extracorporeal shock wave lithotripsy (ESWL). Shock waves are used to break kidney stones into small pieces that can more easily travel through the urinary tract. The doctor uses an X-ray machine to pinpoint the stone’s location and target the shock waves.
- Laser lithotripsy. With this procedure, a small camera is inserted into the urethra and navigated up to the stone. A laser fiber is then used to break the kidney stone into fragments, which are removed using a tiny wire retrieval device. Smaller fragments are able to pass through urination
- Percutaneous nephrolithotomy. This is a minimally invasive surgical procedure that is used to remove large kidney stones or stones that have become lodged in the ureter, the tube that connects the kidney and bladder, and are unable to be removed via the methods above. The surgeon inserts a hollow tube into the kidney through a small incision in the patient’s back, which is less than finger-width in size. A camera is then passed through this tube and the stone is broken apart and suctioned out completely.
Kidney Cancer
Kidney cancer begins with cells of the kidney growing out of control. A tumor may form and the disease can spread to the lymph nodes, lungs and other organs. People over the age of 60 are much more likely to get kidney cancer than young people. Men are twice as likely to develop kidney cancer as women. African-Americans also are at higher risk. So are people who smoke, are obese, have high blood pressure or a family history of kidney cancer.
Most kidney cancers produce no noticeable symptoms. Routine lab tests won’t detect kidney tumors, but sometimes they are discovered incidentally during imaging tests for other conditions.
Here are some of the symptoms of kidney cancer that may appear as the cancer progresses:
- Blood in the urine, which may appear red, brown or rust in color
- Lower back pain or below the ribs, but on just one side
- A lump on your lower back
- Fatigue and loss of appetite
- Unintended weight loss
- Fever
- Bone pain
Your treatment will depend on the stage of your cancer, the exact location and whether the cancer has spread beyond the kidneys. A variety of treatments are available, including:
- Robotic-Assisted Procedures. Our Robotics team uses the da Vinci® Surgical System to perform complex, minimally invasive surgical procedures. This sophisticated system provides our specially trained surgeons a greater range of motion and improved precision in the small, delicate spaces within this area of the body, which results in bleeding, postoperative pain and enhanced recovery after surgery. Some of the leading-edge procedures we offer using the da Vinci® Surgical System include:
- Partial Nephrectomy. Usually done in the early stages of cancer, this procedure involves removing just the cancerous tissue from a kidney, sparing the remainder of the kidney
- Radical Nephrectomy. This involves the removal of the kidney as well as surrounding tissue for larger or more complex tumors that are at higher risk of spread. If necessary, the surgeon may also choose to remove the surrounding lymph nodes, depending on if the cancer has spread.
- Nephroureterectomy. This is removal of kidney, the ureter and a portion of the bladder where it connects with the ureter. This is often a treatment for a less common form of kidney cancer where the cancer is located on the inner lining inside the kidney or ureter.
- Pyeloplasty. To improve impaired kidney flow.
- Sacrocolpopexy. For female patients suffering from vaginal or uterine prolapse.
- Ureteral Reimplant Surgery. To stop urine from backing up into the kidneys.
- Cryotherapy. To treat smaller tumors in the kidney, doctors use a cold gas to freeze and destroy the cancerous tissue. This is a minimally invasive procedure where the doctor makes tiny incisions and inserts a small camera to guide the procedure.
Kidney Obstruction
When urine is produced by the kidney it pools in a funnel-shaped area called the renal pelvis before it drains into the ureter and ultimately the bladder. Some people are born with a blood vessel to the kidney that kinks the drainage of urine from the renal pelvis or have an abnormal connection due to scar or narrowing at this area causing impaired drainage of urine from the kidney.
Symptoms of a ureteropelvic junction obstruction (UPJO) are due to urine and pressure building up in the kidney and include:
- Pain
- Nausea
- Kidney stones
- Decrease in renal function over time
The traditional treatment for UPJO was a large open surgical incision under the rib to cut out the scarred area and reconnect the healthy ureter to the renal pelvis called a pyeloplasty. However, at Orlando Health our urologists trained on the da Vinci® Surgical System robotic platform have adapted this technology to perform a minimally invasive pyeloplasty with the same high success rate as obtained with open pyeloplasty (greater than 90%) while avoiding a large incision and associated pain and morbidity.
