This is our urinary system. Kidneys are in the upper part of our abdomen. The urine secreted by the Kidneys are carried by tubes called ureters to the urinary bladder, where urine is stored. From the bladder urine is passed through urethra.
What are the symptoms of stone disease?
The symptoms of stone disease depend of the location of the stone.
Kidney stones
When stones are in the Kidney they cause a dull, continuous pain. They may produce fever sometimes. Rarely patient may pass blood in urine.
Ureteric Stones
When the stones pass through the ureter they cause severe pain called ureteric colic. This is a severe colicky pain that may radiate from loin to groin. The pain may go to scrotum and penis also. When the stone is in the lower part of the ureter patient will have burning sensation in the urethra and while passing urine.
Bladder stones
Bladder stones produce dull lower abdominal pain. Patient will also have burning sensation while passing urine. Sometimes stones block the passage of urine. Patient may difficulty to pass urine or may be totally not able to pass urine.
Urethral stone
Stones in the urethra can stop urine flow and patient may present with inability to pass urine.
What are the treatments for stone disease?
Small stone are usually passed in urine. They are treated with painkillers, antibiotics and other supportive drugs. It is usually considered that stone of less than 7 millimeters are passed easily
Stones bigger than 7 mms need to be removed if they are not passed in urine. They will need surgical removal
What are the methods for removal of stone:
- ESWL (Extracorporeal Shockwave Lithotripsy)
- Cystolithotripsy
- Ureterorenoscopy
- Percutaneous Nephrolithotomy
- Open Surgery
ESWL (Extracorporeal Shockwave Lithotripsy)
ESWL (Extracorporeal Shockwave Lithotripsy) is a method where shockwaves are produced by a machine outside our body and they are beamed over the stone using x ray localization. These shockwaves powder the stone and the powder is passed in urine. There is no anesthesia
Cystolithotripsy
Here an endoscopic instrument called Cystoscope is passed into the bladder and the stone is broken into pieces
Ureterorenoscopy
Here the endoscopic instrument called Ureterorenoscope is passed through the urethra and into the Ureter and the stone is broken using mechanical or laser stone breaking instruments. After breaking the stone, a thin tube called Double J stent is left in the ureter to facilitate passage of broken stones.
Modern flexible ureteroscopes can reach all corners of the Kidney and stones anywhere can be powdered.
Percutaneous Nephrolithotomy
In this method, the Kidney is directly punctured from outside and the passage is widened. A plastic tube is passed to the Kidney itself. Through this tube an endoscopic instrument called Nephroscope is passed and the stone is broken and bits removed. After removal of stone a thin tube called Double J stent is left in the ureter to facilitate passage of any tiny left-over bits of stone.
Open Surgery
The standard open surgery using long incisions to cut the tissues and directly remove the stone from Kidney, ureter or bladder is occasionally necessary for huge stones
What are the complications of stone surgeries?
The endoscopic Urological surgeries are generally safe. However, complications related to infection and anesthesia may happen. Sometimes surgery can fail because the stone is inaccessible to endoscopic instruments. PCNL, where the Kidney is directly punctured can cause excessive bleeding and transfusion may be needed. Rarely, procedures to arrest bleeding may be necessary.
How to prevent further stone formation?
To know how to prevent stone formation, we should understand why stones are formed. The function of our Kidneys is to dissolve unwanted salts from our body and pass them as urine. Urine is nothing but a solution of unwanted salts. While doing this job some Kidneys do not dissolve stones totally. They leave crystals which can only be seen by microscope. These crystals aggregate to form stones. The capacity to dissolve is constitutional. Some conditions like excessive secretion of Paratharmone, a hormone and Hyperuricemia can also cause stone formation.
Stone formation is not due to excessive consumption of certain salts or minerals. Hence we do not advice any food restriction to prevent stone formation. It is advised to consume sufficient water so that stone are passed in urine when they are small in size.