Renal lithiasis, or kidney stones, are solid masses that are formed by aggregation of small mineral particles. They usually originate in the kidneys, but can develop anywhere along the urinary tract, including the kidneys, ureters, bladder and urethra. It is known that kidney stones are one of the most painful medical conditions.
Recognizing the symptoms and signs of a kidney stone
Kidney stones cause severe pain. The symptoms may not appear until the stone is inserted into the ureters, a condition known as renal colic. The pain spreads to the back and abdomen. In men, pain can radiate to the groin. The pain of renal colic appears and disappears, but it can be intense. Other symptoms of kidney stones may include:
Blood in the urine (red, pink or brown)
Discoloration or foul odor of urine
Frequent need to urinate
Urinate in small amounts
In the case of a small kidney stone , you may not have any pain or symptoms as the stone passes through your urinary tract.
How is kidney lithiasis treated?
- Medication. If you have severe pain, your GP can relieve your pain with an analgesic injection. A second dose may be given after half an hour if you still feel pain. The medication can also be used to treat the symptoms of nausea and vomiting.
- Care at home. You may be advised to wait until the stone is excreted with urine. You can do this by filtering your urine through gauze. Give the stone to your doctor so they can analyze it and help determine any additional treatment you may need. You should drink enough water to make your urine colorless. If your urine is yellow or brown, you are not drinking enough water.
- Hospitalization. If your kidney stone has entered the inside of your ureter and causes severe pain, your doctor may hospitalize you for treatment.
Treatment of large kidney stones
If a kidney stone is too large to remove naturally (6-7 mm in diameter or more), you may need another type of solution. The type of treatment you have will depend on the size and location of the stones.
Extracorporeal shock wave lithotripsy (ESWL). It is the most common way to treat kidney stones that can not be eliminated in the urine. It involves the use of ultrasound to identify where the kidney stone is. Subsequently, ultrasound shock waves are sent to the stone to break it into smaller pieces, so that it can pass through the urine.
Ureteroscopy. If a kidney stone gets stuck in the ureter, you may need ureteroscopy. It involves passing a ureteroscope through the urethra and into the bladder. Then it goes to your ureter where the stone is stuck. It may be necessary to temporarily insert a plastic tube called a stent to allow stone fragments to drain into the bladder.
Percutaneous nephrolithotomy (NLP). It is an alternative procedure that can be used for larger calculations. It can also be used if the ESWL is not suitable, for example, because the patient suffers from obesity . A small incision is made in your back and the nephroscope passes through it to your kidney. The stone is extracted or broken into smaller pieces using a laser or pneumatic energy.
Nowadays, open surgery for the removal of kidney stones is very unusual (less than 1% of cases require this type of surgery). It is usually only used if there is a very large stone or an abnormal anatomy. During open surgery, an incision will be made in your back so that the surgeon can access your ureter and kidney.
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Treatment of uric acid stones
If you have a uric acid stone, you may be advised to drink about three liters of water each day to try to dissolve it. Uric acid stones are much milder than other types of kidney stones , and can be reduced if exposed to alkaline fluids.
You may need to take some medication to make your urine more alkaline before the uric acid calculation begins to dissolve.
Complications of treatment
After the treatment of large kidney stones complications can arise, which will depend on the type of treatment and the size and position of your calculations. It is estimated that between 5% and 9% of people may experience complications after a ureteroscopy. Complications may include:
Sepsis , an infection that spreads through the blood.
Blocked ureter, caused by stone fragments.
Injury in the ureter.
Bleeding during surgery.
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