Ask the experts

Do all Kidney Stones Cause Pain? 

Kidney stones are small, hard mineral deposits that form in the kidney. They may stay in the kidney or travel down the urinary tract. Kidney stones are one of the most common problems of the urinary system. Not all stones are able to pass through the urinary tract on their own. But stones that are smaller, such as those the size of a grain of sand or even a small pearl, can pass.

Stones in the kidney often do not cause any symptoms and can go undiagnosed. When a stone leaves the kidney, it travels to the bladder through the ureter. Sometimes, the stone can become lodged in the ureter. When this happens, the stone blocks the flow of urine out of the kidney and it can cause the kidney to swell, often causing a lot of pain. 

A sharp, cramping pain in the back and side, often moving to the lower abdomen or groin may occur with stones. The pain often starts suddenly and comes in waves. It can come and go as the body tries to get rid of the stone. A feeling of an intense need to urinate is also possible with stones. 

If you’ve had a kidney stone and want to avoid another one, drink water throughout the day to stay hydrated. Remember to drink more to replace fluids you’ve lost when you sweat from exercise or are in hot weather. Try to avoid eating too much food high in oxalates. Common foods high in oxalates include blueberries, chocolate, peanut butter or spinach. You may want to also reduce the amount of animal protein (red meat, pork, etc.) in your diet. 

Dr. Timothy D. Averch is professor of urology and director of Endourology at the University of Pittsburgh School of Medicine. He is also director of the UPMC Kidney Stone Center.

How are Ultrasounds, MRIs and CT Scans used in Urology? 

Ultrasound (also called ultrasonography, or a sonogram) uses high-frequency sound waves to create real-time images. It’s a simple, flexible and painless way for urologists to look at many organs without using dyes or radiation. These exams help check what is causing you pain, swelling or an infection. An ultrasound is painless, safe and often risk-free. Urologists use ultrasound to look at the kidneys, bladder and testicles.

Magnetic resonance imaging (MRI) is also a painless imaging test that uses radio waves and a strong magnetic field to create highly detailed pictures. Since the MRI can create three-dimensional (3-D) images of organs and other masses, it is often used for detection, diagnosis and treatment. 

An MRI can help doctors find cancer in the body and show if and where the cancer has spread. MRI is being used more for prostate biopsies that help urologists look for cancer. People with pacemakers or other metallic pieces should not get an MRI. Sometimes intravenous contrast (“dye”) is injected to help define structures.

The CT scan is used by doctors to see and test cross-sectional slices of tissue and organs. It combines X-rays and computer calculations for detailed images. These scans can accurately gather real-time images in seconds, with no gaps. It can show solid vs. liquid structures, when intravenous radiopaque contrast (“dye”) is injected. 

Specialized CT scans can make 3-D images of the kidney and blood supply. These can show problems with blood flow and offer a “road map” for planning surgeries. CT scans are generally safe, efficient, and effective, with minor risks. Some patients can have an allergic reaction to the radiopaque dye. CT scans are one of the best tools for finding problems in the urinary tract, including stones and masses. 

Dr. Ajay K. Nangia is professor of Urology and Clinical Director of Andrology at the University of Kansas Medical Center. He is a member of the Urology Care Foundation’s Public Education Council. 

What Simple Changes Can Help Men Avoid Fertility Problems

Male infertility is when a man has a health issue that lowers the chances of his female partner’s pregnancy. It’s most often caused by issues linked to sperm production or sperm delivery. 

High temperatures and heat can damage sperm counts in men. With this in mind, men with fertility issues should avoid hot tubs, steam rooms, saunas and electric blankets. Minimizing the amount of alcohol, you drink and not smoking are two additional ways to minimize damage to sperm counts. 

I’m often asked if keeping a cell phone in your pocket can cause fertility problems. While there hasn’t been any strong data to support the claim, the cell waves can be harmful and it’s better to be super cautious than to risk damaging sperm levels. 

Men should also avoid keeping their laptop computers on their laps! The heat emitting from a laptop can raise the scrotum’s overall temperature and harm sperm levels. When playing a contact sport, make sure to wear an athletic cup. Traumatic groin injuries can seriously damage a man’s fertility health.

Dr. Tobias Köhler is a urologist at the Mayo Clinic in Rochester, Minnesota. He has specialty interest and fellowship training in men’s health (andrology).  |  SPRING 2018  |  UROLOGYHEALTH extra