Scott Webb (Host): This is Vital Signs, Candid Conversations With Providers Who Care. I'm Scott Webb, and today we're talking about kidney stones, which are unpleasant, but they are treatable and in many cases preventable. And joining me today to tell us more is Dr. Himanshu Aggarwal. He's the Chief of Urology and the Chief of Urogynecology and Reconstructive Urology at Jackson Hospital. Doctor, welcome to the podcast.

Himanshu Aggarwal, MD: Yeah. Thank you. I'm glad to be here to be talking about kidney stones.

Host: Yeah, there's probably never a bad time to talk about kidney stones, Doctor, but we're going to do that today and we're going to get to a exciting new procedure that you're going to be doing soon there and would be available to folks. But let's start with maybe the most basic one. What are kidney stones?

Himanshu Aggarwal, MD: So kidney stones are marble shaped mineral deposits. They are formed in the kidney. They can be very painful. They can cause a lot of symptoms, a lot of time they're asymptomatic, meaning no symptoms. However, they can cause severe pain on the side, can cause fever, chills, and blood in the urine.

Host: Yeah, that checks out Doctor. I've had kidney stones and they were incredibly painful. Sadly, I was not asymptomatic, I was symptomatic and it hurt. So what are some of the other symptoms we should be on the lookout for?

Himanshu Aggarwal, MD: As you said, the kidney stones can be very painful. In fact, the pain level can be as high as a labor pain. So a lot of my male patients tell me this is more than the labor pain my wife had. And that's true. So a lot of symptoms include severe pain on the side, as I said, fever and they can really get you sick if they get stuck in the ureter and cause the urine to back and cause infection.

Host: Again, that all checks out. That's been my experience. My wife and I might disagree as to whether or not they hurt as much as her labor pains, but maybe that's a separate podcast. So what do we do, Doctor? If we have symptoms?

Himanshu Aggarwal, MD: First of all, if you have symptoms which includes severe pain, if the pain is severe enough, then you need to go to nearest emergency room. And, the provider there will do a CT scan or any kind of imaging to see what size of the kidney stone, where the location of the kidney stone is.

And based on your symptoms, based on your clinical picture, they may actually send you home depending on if your pain is controlled or if you don't have any signs of infection. Otherwise, you may need to be admitted and somebody has to take care of the kidney stone, most likely a urologist.

Host: Right, and that's why it's great to have you here, great to have your expertise. Is there any way, Doctor, to prevent kidney stones? Is it drinking more water, eating better, exercising more? What could we do? Because it was the worst pain of my life. I never want them again.

Himanshu Aggarwal, MD: Yes, so kidney stones are mostly preventable. A lot of people make kidney stones, and especially in the south, especially because of the dehydration and the warm weather. But there are other reasons to make kidney stones as well, like, imbalance of electrolytes and minerals in the body. So we at Jackson Hospital, not only treat kidney stones with minimally invasive techniques, but we also do some workup to find out why you make kidney stones so we can stop it from coming back in future.

It just involves simple, blood test and some urine testing. Also, if we have a fragment of the kidney stone or if you pass the kidney stone, we can send that for analysis to find out what kind of kidney stone it is. So based on those tests, sometime we recommend dietary changes. Sometime we recommend increasing water fluid intake.

Sometimes we recommend some medications also, sometimes some supplements. In general, 95% of the kidney stones can be prevented, and you may never have any other kidney stone episode if you comply with all those instructions.

Host: Yeah, compliance is key and I, I've been drinking a lot of water, since I had my kidney stones. You mentioned treatment there. Let's talk about treatment options.

Himanshu Aggarwal, MD: So majority of the time, as I said, if the kidney stones are not painful or not causing any sign of infection, they can be watched and you may be able to pass them depending on the size and location of the kidney stone. There are some medications we can help you to pass the kidney stones. If you are not able to pass the stone or are in severe pain, or there's a sign of infection, we have many latest cutting edge technologies and we can remove the kidney stones with minimally invasive techniques these days.

You know, we have two major techniques. One of them is sound wave technology, and another one is using the laser. Both of them are very good and effective, depending on where the stone is and how big the stone is and the characteristics of the stones. None of those techniques involve any kind of cutting on the body or any, any sutures or stitches. Both of them are minimally invasive. Now, if the kidney stones are very big, sometime we have a little more invasive technique called PCNL, which can also remove the kidney stones without making any big cuts or sutures on the body.

Host: I'm going to hope that I can say this out loud, doctor, I was reading about, vacuum Aspiration Ureteroscopy or VURS, and I know that that's a cutting edge new kidney stone removal procedure. And you were saying you've got one of those procedures coming up soon, so tell us more about that.

Himanshu Aggarwal, MD: So yes, this is actually a very exciting thing because this technique has been only around for a couple of years in the country, and we are excited to offer this at Jackson Hospital now, and this is the only hospital in the entire Central Alabama to offer this kind of technique. So in nutshell, this involves getting to the stone with a scope, using a laser to break it up, but also at the same time using a vacuum device to remove all those fragments. Because of this technique, the procedure is faster, more reliable and the success rate is very high up to 97%. Now, if you remember, I mentioned if you have very large stones, sometime we do a technique called PCNL. With this technique, in fact, we are able to avoid even that kind of procedure, and even the large stones can be done with this new latest cutting edge technology.

Host: It's really amazing. I love as a patient, of course, and we're all patients on some level, Doctor, right? I love hearing how about the tools that you have in your toolbox? You've got lasers, you've got vacuums. You've got quite a toolbox there, right?

Himanshu Aggarwal, MD: Yes, absolutely. It's very exciting.

Host: Yeah. It really is. Hard to believe we can get excited about kidney stones, but as someone who's had them Doctor and never wants them again, I love hearing about all the options from diagnosis to treatment. Really appreciate your time and your expertise today.

Himanshu Aggarwal, MD: Thank you. I'm glad to be here. Thank you.

Host: And for more information, please visit jacksonclinic.org/specialty-care/urology. And if you found this podcast helpful, please do share it on your social media. I'm Scott Webb, and thanks so much again for being a part of Vital Signs Candid Conversations with Providers who Care.