Miguel Finds the Right Plan for Kidney Stone Treatment at Lurie Children’s

September 17, 2019

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This computed tomography (CT) image shows a large stone which measures about 2.3 cm in the central area of the right kidney, as well as a smaller stone in the lower pole measuring about 4.4 mm. There are no stones seen in the left kidney and no stones in either the ureter or the bladder.

When Miguel was only two, he woke up from sleep most nights screaming in pain and discomfort.

The toddler endured recurring urinary tract infections, doctors told his mom, Maria, meaning Miguel felt a burning sensation of having to urinate almost constantly.

“We kept going home with a prescription, but I knew it wouldn’t fix anything,” she said.

Finally, the pediatrician in their rural Illinois hometown referred Maria and Miguel to a urologist at a Chicago hospital. The family found out Miguel had kidney stones due to cystinuria, a condition that affects the kidneys and bladder, often causing painful stones and urinary tract infections.

Miguel underwent a handful of surgeries over two years in which doctors removed bladder and kidney stones from his body, and the boy ultimately received a stent in his ureter to help urine pass through his body. While kidney stones often pass on their own, some people, like Miguel, need help passing or removing them with medications or surgeries.

Back at home, Miguel’s discomfort persisted. He had many additional kidney stones, causing nausea and pain in his back and when he used the bathroom.

The Chicago urologist told the family Miguel needed yet another extensive surgery for his long-term recovery.

“All through the night, he would be crying in pain,” Maria said. “I knew something else was wrong.”

Expertise at Lurie Children’s

Around the same time, a change in her insurance brought Maria and Miguel to Ann & Robert H. Lurie Children’s Hospital of Chicago, where the family met with pediatric urologist Dr. Bruce Lindgren.

In addition to being a urologist, Dr. Lindgren also helps train medical students and urology residents and fellows in urology as an associate professor of Urology at Northwestern Feinberg School of Medicine.

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Dr. Lindgren, an expert in minimally invasive urological surgery, gently advances the endoscope in search of a stone.

Dr. Lindgren is the director of minimally invasive urological surgery at Lurie Children’s. He also helps train medical students and urology residents and fellows in urology as an associate professor of Urology at Northwestern Feinberg School of Medicine.

The expertise paid off for Maria’s son. After reviewing Miguel’s scans and meeting with the family, Dr. Lindgren was able to remove Miguel’s stent and many of his additional stones through a procedure known as percutaneous nephrolithotomy.

In this minimally invasive procedure, the surgeon makes a small incision in the child’s back just above the kidney, then uses imaging to help guide an endoscope, or nephroscope, to the stone. The surgical team can either remove the stone using a grasping forcep or basket passed through the instrument, or break up the stone into smaller pieces before removing it. There is less bleeding and faster healing in this procedure than with open-field surgery because the incision is smaller.

Dr. Lindgren also performed ureteroscopy on Miguel to visualize his urinary tract and see if other stones existed. In this outpatient procedure, a fiber-optic or digital imaging instrument is inserted into a child’s bladder via the urethra, and then manipulated up the ureter to the kidney to visualize stones. In some cases, especially when kidney stones are smaller than 1.5 centimeters, ureteroscopy can be used to remove or break up a child’s kidney stones in combination with a basket or laser.

A nurse helped explain the details of the procedures to Maria, she said, which was comforting.

At Lurie Children’s, a multidisciplinary team including Dr. Lindgren, Dr. Craig Langman, Head of the Division of Kidney Diseases, and others work together to provide comprehensive care to patients with complex kidney conditions like Miguel’s. The team found medication and dietary changes that would help prevent Miguel’s body from forming more stones.

After these successful efforts, Maria got the best news yet: Miguel wouldn’t need another extensive surgery.

“Before we got to Lurie Children’s, every doctor’s appointment meant scheduling a new surgery,” Maria said. “Dr. Lindgren’s care and concern gave our family comfort and peace after many worried nights with no sleep.”

Healing and Growing up

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Miguel, with his best friend and sister Isabel, feels much better since he had surgery with Dr. Lindgren and started seeing nephrologists at Lurie Children’s. Dr. Lindgren removed many of Miguel’s bladder and kidney stones using a minimally invasive procedure called a percutaneous nephrolithotomy.

Miguel, now 5, continues to see nephrologists at Lurie Children’s a few times a year. Since his surgery with Dr. Lindgren, he hasn’t developed any new kidney stones.

These days, Miguel is a playful boy with almost no pain, his mom said. He sleeps through the night, loves eating spaghetti and pizza and explores his uncle’s farm with his older sister and best friend, Isabel.

“People see him and can’t believe everything he’s been through,” said Maria. “I am so thankful Lurie Children’s could help him.”

Learn more about Lurie Children's Division of Urology