How do you know if you have a stone?
Urates precipitate in an acidic environment. Their formation is promoted by an excess of purine compounds in food. Phosphates occur in an alkaline environment and are observed with excessive consumption of vegetables and fruits.
Urinary tract infection (pyelonephritis) is also of great importance in stone formation.
Kidney stones: symptoms
Signs of urolithiasis vary in their diversity – from the complete absence of clinical symptoms to such serious phenomena as renal colic and kidney block.
- burning and stinging above the pubis and in the urethra during urination – explained by the spontaneous release of small pebbles, the so-called “sand”;
- back painassociated with sudden shaking, drinking a lot (especially after drinking liquids such as beer and pickles);
- высокая температура when an infection occurs;
- renal colic – the most unpleasant complication of urolithiasis, manifested by sharp pain in the lower back with irradiation (spread) along the ureter, can
- pain can “radiate” to the leg, stomach, genitals;
- patients often note cloudy urineand appearance of blood in it (typical of renal colic).
The nature of the pain and its location can give the doctor information about the location of the stones: in the kidney itself, ureter or bladder. X-rays and ultrasound can help confirm this assumption.
In the earliest stages, the disease may not manifest itself in any way – kidney stones are often discovered by chance on an ultrasound. Sometimes even large stones do not show up until the patient experiences pain.
How are kidney stones treated?
Until relatively recently, the only way to remove kidney stones was surgery. Modern treatment methods make it possible to avoid surgery. Today, surgery is performed in less than 5% of cases.
In order to begin treatment of urolithiasis, its correct diagnosis is necessary. The fact is that kidney stones can be of completely different types and they need to be treated in completely different ways.
For diagnostic purposes, a urologist may prescribe the following tests:
- Analysis of urine general and according to Nechiporenko, which will detect blood and salt content in the urine that exceeds normal levels, and also determine the level of acidity
- blood test general and biochemical, which will show the presence of inflammatory processes in the body; a blood test can be used to judge the composition of the stone
Further medical examination may include:
- Ultrasound of the kidneys: will allow you to identify the size of the stones, their more detailed location, as well as how dangerous they are and what harm they have already caused to your body
- roentgen: will allow you to accurately determine where the stones are located, as well as make a final diagnosis
Only on the basis of these obtained data will the doctor be able to make a decision and select appropriate treatment methods.
In order for the tests to be reliable, the POSITIVMED medical center recommends paying attention to the rules for taking urine tests.
Further treatment for each patient is purely individual and necessarily comprehensive. For small stones (up to 0,5 cm), conservative therapy is prescribed, which is based on the use of antispasmodic drugs (no-spa, spasmalgin, baralgin, etc.). Antispasmodics promote the passage of stones. Also for this purpose, you can use diuretics and herbal remedies (“Urolesan”, “Fitolit”).
Stones measuring about 1 cm are removed non-contact method of extracorporeal shock wave lithotripsy, which consists of remote crushing of stone using electromagnetic waves. A crushing session lasts about 40 minutes, but one procedure is usually not enough (up to 4-5 sessions are needed). After this, the crushed parts of the stone come away on their own. To make the process go faster, you need to drink a lot of water and adhere to a special diet (limit the consumption of spicy, smoked, salty foods).
If the ultrasound showed that the stones are large and inactive, or the patient wants to get rid of them quickly (in one session), it is used intracorporeal lithotripsy method. With this method, a surgical instrument is inserted into the urinary tract under anesthesia, the stones are crushed using a laser, and their fragments are immediately removed. Many people, having learned about their diagnosis, try to get rid of stones using traditional methods. But only stones up to 0,5 cm in size can be removed independently.
After the stones pass, the person is considered relatively healthy. But relapses are possible. To prevent them, you should take courses of diuretics or herbal remedies twice a year.
Prevention of urolithiasis
- INCREASE YOUR FLUID CONSUMPTION;
- LIMIT YOUR CONSUMPTION OF ALCOHOL BEVERAGES;
- REDUCE YOUR SALT CONSUMPTION;
- DO NOT OVERCOOL;
If the disease does occur and treatment has been completed, it is recommended to take a general urine test at least once a year. You should also stick to your diet. Diet therapy will be prescribed by a urologist and depends on the composition of the stones.
With uric acid stones, limit the consumption of meat broths, liver, kidneys, with phosphate stones – milk, vegetables, fruits, with oxalates – sorrel, spinach, lettuce, other vegetables and milk. Along with the diet, drinking plenty of fluids (8 – 10 glasses of liquid per day) is recommended.
The appearance of such stones is a consequence of urolithiasis. The presence of stones in the urethra is accompanied by pain, difficulty urinating up to acute retention, a change in the shape of the urine stream or its weakening. Stones in the urethra can be primary or secondary. Primary stones initially form in the urethra; secondary stones form in the kidneys or bladder and descend into the lumen of the urethra. Most often, urology encounters secondary stones in the urethra. In women, stones in the excretory duct of the bladder are much less common than in men. This is explained by the peculiarities of female anatomy and the structure of the urethra.
Prognosis and prevention of urethral stones
With timely removal of a calculus from the urethra, the prognosis for a disease that interferes with the outflow of urine from the bladder will be most favorable, since it will help to avoid complications and the occurrence of diseases such as urethritis, paraurethritis, the formation of urethral bedsores and fistulas. In order to further exclude the re-formation of stones in the bladder and kidneys, and, consequently, their appearance in the urethra, it is necessary to make adjustments to the food and drinking regime, and eliminate other causes of stones in the bladder and kidneys.
Causes of formation of urethral stones
Primary urethral calculi are most common in men. They appear in the urethra against the background of chronic urethritis, prostatitis, prostate adenoma. Conditions for the formation of urethral stones can be fistulas, urethral diverticula, and urethral strictures. The configuration of urethral stones depends on the part of the urethra in which they form and grow. Secondary stones in the urethra are a manifestation of urolithiasis, i.e. the presence of stones in the bladder or kidneys. These stones descend from the upper urinary tract, get stuck in some part of the urethra (most often in the membranous or prostatic parts, as well as at the level of the scaphoid fossa) and cause corresponding symptoms. The shape of stones in the urethra and their number may vary. The cause of the formation of secondary stones in the urethra are mineral metabolism disorders that occur in the body due to bone injuries and osteoporosis. Among other reasons that cause the formation of secondary stones in the urethra, modern urology identifies errors in nutrition and drinking rations, dehydration, and urinary tract infections. Since the formation of stones in the urethra is a consequence of urolithiasis, the chemical composition of stones in the urethra will be similar to kidney stones.
Symptoms of stones in the urethra
A stone in the urethra can have different symptoms. How pronounced they will be depends on the shape of the stones, the region of their localization, quantity, size, and time spent in the urethra. Obstruction of the lumen of the urethra by a stone is usually accompanied by severe pain. In addition, if there are stones in the urethra, the patient experiences difficulty urinating, weakened urine stream, and hematuria. If a stone is stuck in the urethra and the stone completely blocks the lumen of the urethra, then acute urinary retention occurs. Stones may be located in the posterior urethra, causing the patient severe pain when walking and while sitting. If stones are in the urethra for a long time, the development of urostasis begins (impaired outflow of urine from the bladder). When stones are located in the urethra and partially in the bladder, there is a possibility of developing urinary incontinence. The presence of stones in the urethra can cause severe pain during sexual intercourse.
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Diagnosis of urethral stones
The presence of stones in the urethra can be diagnosed based on characteristic symptoms, data obtained by palpation and the results of instrumental studies. In men, a stone in the urethra is determined by palpation of the perineum or hanging part of the urethra. If stones are located in the posterior parts of the urethra, then digital rectal examination will help identify them. Women undergo a gynecological examination to diagnose stones in the urethra. In this case, a calculus in the urethra can be felt through the anterior wall of the vagina. An ultrasound may be necessary to diagnose urethral stones. It will allow you to visualize the hyperechoic urethral formation, which gives an acoustic shadow. In addition, to identify stones in the urethra, the patient undergoes a general urine test, which should confirm the presence of an inflammatory process and hematuria. The presence of stones in the urethra can be determined by inserting a special metal bougie into the urethra. During this procedure, a characteristic obstruction in the urethra will be felt or a feeling of friction will appear. To conduct a differential diagnosis and exclude the presence of foreign bodies in the urethra, the patient is prescribed survey urography, urethrography, and urethroscopy. Observational urograms often show the shadow of stones. When conducting an X-ray contrast study, the presence of stones in the urethra can be determined by increased contrast or a filling defect. X-ray and endoscopic examination of the urethra makes it possible to determine the location of the stone, its size and quantity. These studies of the urethra and urinary tract also help in choosing a method for removing stones from the urinary canal.
Treatment of urethral stones
Methods of providing medical assistance when a patient has stones in the urethra can be different. In any case, treatment consists of removing stones from the urethra. If the stones are located in the anterior urethra, then removal of the stones is carried out using urethral forceps. When stones are localized in the scaphoid fossa, they are removed using a clamp or tweezers. If the stones in the urethra are mobile and smooth, then they can be moved closer to the external opening of the urethra using massaging movements. If the external opening is narrow enough, the doctor resorts to cutting it. If the stones are located in the posterior parts of the urethra, you can try to push them using a bougie or a metal catheter into the bladder. In this case, the next step will be the removal of stones from the bladder. Sometimes stones that have descended into the urethra from the bladder or kidneys can pass on their own. For this, the patient is prescribed antispasmodics and sitz baths, but it is not always possible to achieve the desired effect in this way. If all attempts to instrumentally remove stones from the urethra are unsuccessful, then the patient undergoes external urethrolithotomy and removal of stones. Removal of stones located in the posterior urethra is performed surgically through an open bladder. Simultaneously with the removal of urethral stones, it is necessary to eliminate the causes of stone formation: bladder or kidney stones, urethral strictures, prostate adenoma.
This article is posted for educational purposes only and does not constitute scientific material or professional medical advice. Consult your doctor for diagnosis and treatment.
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- Balanite
- Vesiculitis
- kidney dystopia
- Benign bladder tumor
- Foreign body of the bladder
- Stones in the urethra
- Kidney stones
- Stones of the bladder
- Ureteral stones
- Urachal cyst
- Urolithiasis disease
- Urinary incontinence
- neurogenic bladder
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- nephrotic syndrome
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- Acute glomerulonephritis
- Acute pyelonephritis
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- horseshoe kidney
- Polycystic kidney disease
- Renal colic
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