Ask the experts

What should I know about traveling with kidney stones?

If you have a history of kidney stones, especially if you have them often, talk to your doctor before you make a long trip. Half of all people who get a stone will get another one. Based on the type of stones you have had, your current health issues, age and nutrition needs, your doctor can give you tips to prevent stones.

Even if you are taking steps to prevent kidney stones, one may cause pain while you’re traveling. Non-narcotic medicine should work but you may want to talk with your doctor about how to prepare for pain relief. If you are advised to have a prescription for pain medicine to take with you, fill the prescription in advance of your trip. If you’re traveling by plane, keep any medication in your carry-on luggage in case your checked bags get lost.

Ask your doctor if it would be a good idea to have a plain abdominal X-ray or ultrasound before your trip to see if there are any stones that may need treatment before you go.

While you are traveling, drink plenty of water to lower your risk of forming new stones. Aim to replace fluids lost when you sweat from exercise or in hot weather. All fluids count, but try to drink water or mostly no-calorie or low-calorie drinks. This may mean limiting sugar-sweetened or alcoholic drinks.

Other tips for preventing kidney stones include reducing the amount of salt in your diet and eating at least five to nine servings of fruits and vegetables daily. If your doctor believes your diet is increasing your risk for stones, they may tell you to eat less meat.

Dr. Timothy Averch, a urologist at Prisma Health–Midlands, focuses on kidney stone disease, quality improvement and patient safety.

What happens if I have a kidney injury on vacation?

When blunt force from a car accident, sports injury or fall injures a kidney, the injury will certainly be painful. But it may not be harmful.

Minor kidney injuries can cause blood in urine, pain or abdominal bruising. For these, treatment begins with careful fluid control. Rest can be helpful too. Often, the kidney can heal itself.

If the injury is worse, with a tear or cut in the kidney for example, bleeding can be extreme. Treatment with surgery or embolization may be needed. For embolization, the doctor uses a catheter to block bleeding. If there is a tear, surgery would repair the injury. The kidneys are strong, so it’s very rare that a kidney needs to be removed due to injury.

In some cases, people feel sudden pain in the deep part of their middle to upper back. This type of pain may not be from a clear impact or accident. In these cases, it is of great value to check for kidney stones, a urinary tract infection or some other problem. Symptoms can include fever, vomiting or pain when passing urine.

Even on vacation, if you have symptoms like these, you should get medical attention. The best place to start is with your own doctor. Virtual telehealth visits are easy now and a great place to start. Your doctor can tell you if you should seek urgent or emergency care, or if you can wait. You may also want to check with your insurance company to learn if you need special coverage while traveling.

The good news is most people heal after a kidney injury. The key is to get diagnosed and treated quickly. What you don’t want is to let an injury develop into a lifelong problem.

Dr. Necole Streeper, a urologist at Penn State Health, specializes in kidney stone surgery and prevention.

Can intense exercise cause hematuria?

If you see blood in your urine after an intense workout, you may have something called “exercise-induced hematuria.” It is most common in runners, especially those running more than 10,000 meters (more than 6 miles). It can also occur after any prolonged, intense physical activity like high intensity interval training. The good news is this problem will most likely go away on its own as you recover from your workout.

Working out can affect the process of filtering urine from the bloodstream, which allows red blood cells to mix with urine. If you stop having blood in your urine 72 hours after intense exercise, you do not likely need to worry. But, if blood in the urine keeps showing up, doesn’t go away after 72 hours, if you notice decreased or no urine output, or have any questions, you should talk to your doctor. It may be a good idea to have your urine looked at through a microscope. You should also see your doctor if you have symptoms such as flank pain or fever. These can be signs of an infection or kidney stone. Certain medications such as blood thinners may worsen blood in the urine.

Blood in urine can also be caused by other conditions. While most of these are not cancer related, blood in the urine can also result from urinary tract cancers. If you are older than 40, have a history of smoking, or a family history of urinary tract cancers, you should discuss screening with your doctor whenever you see blood in your urine.

To help prevent exercise-induced hematuria, drink plenty of water during exercise. Being dehydrated may make blood in the urine due to exercise worse. If you play contact sports, wear proper protective gear.

Dr. Ben Ristau, a urologist at UConn Health, specializes in the surgical management of genitourinary cancers with a focus on robotic and minimally invasive approaches.  |  SUMMER 2022  |  UROLOGYHEALTH extra