Urinary Stones or Urolithiasis is the formation of calculi (or) stones anywhere in the urinary system (or) tract that includes bladder stones, kidney stones , urethral stones and ureteric stones. Urinary calculi (or) stones are the most common cause of acute urethral obstruction. 5% of women and 12% of male are effecting with this urolithiasis. Renal stones remain asymptomatic but most will results in pain. Small stones that arise in kidney are most likely to pass into the ureter where they may form renal colic. The composition of urinary tract stones varies widely depending upon metabolic alterations, geography, presence of infection and size. Most common composition of stones includes: calcium phosphate and oxalate- 75%, struvite- 15%, uric acid- 5-8%, cystine-1%.
Fixed renal pain is the common symptom. Vomiting and sometimes fever are also symptoms. According to the position of the stone the pain may generate in different parts, like if the stone is upper one – third of ureter – pain radiates to the perineum, if it is at the pelvic brim – pain radiates on inner aspect of thigh, if the stone is localized in the bladder neck (or) urethra pain may present as tip of penis.
The clinical diagnosis should be supported by appropriate imaging. Ultrasound should be the primary diagnostic imaging tool. Blood analysis includes measurement of creatinine and urine analysis measurement of urine volume.
Main causes for the urolithiasis is decreased volume of urine, urinary tract malformation like horseshoe kidney and duplex collection system, urinary tract infections especially with urease producing bacteria, hyperoxaluria (high dietary oxalate), decrease in urinary citrate levels leading to deposition of calcium, increased excretion of stone forming components.
Dietary measures like increase in fluid intake and therefore, an increase in urine output is recommended. Avoid excessive salt, calcium, oxalate and protein intake in diet. Anyone with a past history of urolithiasis should have a regular screening performed as the recurrence rate is high.
Treatments Offered for Urinary Stones
- Laser Treaments
- Rigid Ureteroscopy and Laser Lithotripsy (for kidney stones)
- Flexible Ureteroscopy and Laser Lithotripsy (for kidney Stones)
- Non Surgical Treatment
- Ureteroscopy (for kidney stones)
- ESWL ( Shock wave Lithotripsy) (for kidney stones)
- Surgical Treatment
- Mini-PCNL Treatment (for kidney stones)
- Micro-PCNL Treatment (for kidney stones)
- PCNL Treatment (for kidney stones)
- Open Surgery
- Pyelolithotomy(for bladder stones)
- Ureterolithotomy(for ureteral stones)
- Open prostatectomy(for bladder stones)