Urolithiasis

What is urolithiasis?

This is a situation where in the urinary system there are deposits, colloquially called "stones", formed as a result of the precipitation of certain substances, such as calcium oxalates, less often: calcium phosphates, struvite and cystine. They can arise in any section of the urinary tract. Typical locations for stone deposition are the calyxes and renal pelvis. From here, they often move to the ureters and the bladder. Deposits that reach considerable size can damage the kidneys.

Make an appointment now - to a doctor who treats urolithiasis in our hospital

{article 531}

[title]

[image-intro]
[readmore text="Read more"]{/article}

Symptoms of kidney stones

The main and most troublesome symptom of this disease is pain - the so-called renal colic. Characteristic for it are: occurrence in the lumbar spine, radiation to the inner surface of the thighs and to the genitals. In the course of renal colic, vomiting and nausea may also occur. Pain ailments are caused by irritation of the walls of the urinary system organs (usually the ureters) by the deposits moving through them. When kidney stones are accompanied by a urinary tract infection (UTI), colic may be accompanied by chills and fever. The pain may go away on its own. This happens when the plaque "shifts" into the bladder and is thus excreted in the urine.

Diagnosis of kidney stones

The symptoms described above are characteristic of this ailment, hence the interview conducted by the doctor alone allows for an initial diagnosis of nephrolithiasis. A positive Goldflam symptom (causing severe pain as a result of a slight impact on the patient's lumbar region) during the examination also supports the discussed diagnosis. In order to make a diagnosis, the following are also performed:

general urine test - usually there is haematuria or haematuria. In the presence of urinary tract infection, bacteriuria (presence of bacteria in the urine) and leukocyturia (presence of leukocytes in the urine) are also possible

- blood test - usually leukocytosis (increase in the number of leukocytes in the blood). Increased CRP and ESR in the presence of UTIs.

Imaging tests are also performed to visualize deposits within the urinary tract. The most common methods used for this purpose are: abdominal X-ray and ultrasound. In case of doubt, diagnostics may be extended to include computed tomography. Nephrolithiasis can also be diagnosed by accident, when the patient is examined for another ailment, e.g. during an ultrasound of the abdominal cavity.

The causes of kidney stones

Based on the composition of deposits in the urinary system, we can determine the causes of their formation. These are the most common:

- endocrine diseases: hyperparathyroidism, chronic diseases of the digestive system, certain cancers or hematological diseases, e.g. lymphomas.

- dietary mistakes: habitual intake of vitamin C, diet rich in oxalate, low-calcium diet,

- recurrent urinary tract infections - refers to the formation of struvite deposits.

Complications of kidney stones

The most common consequence of untreated nephrolithiasis is its recurrence. The risk of recurrence in the absence of treatment increases by several percent with each subsequent year. Another common consequence of urinary tract deposits is recurrent urinary tract infections. There is a risk of hydronephrosis in the event of long-term obstruction of urine flow caused by stones. Due to the formation of cast struvite deposits in the calyx and renal pelvis, damage to the interstitial tissue of the kidneys may occur. This type of kidney stone is therefore particularly dangerous.

Treatment

In order to relieve pain, non-steroidal anti-inflammatory drugs, opioid drugs and drugs that relax the smooth muscle of the urinary system are used. If: the deposit is> 5mm in diameter, symptoms are accompanied by nausea or vomiting, and pharmacological treatment does not bring results, invasive treatment of nephrolithiasis should be considered. For this purpose, the following are most often carried out:

ESWL (extracorporeal shock wave lithotripsy) - extracorporeal lithotripsy. It consists in breaking the deposits with the use of electromagnetic or electrohydraulic waves. The procedure is performed under anesthesia.
PCNL (percutaneous nephrolithotomy) - percutaneous nephrolithotripsy. The purpose of this method is also to break down the deposit. This is done using an endoscope, which is introduced into the urinary system through carefully located puncture
URSL (ureteroscopy and laser stone fragmentation) - Ureterorenoscopic lithotripsy. Using an endoscope (ureterorenoscope) inserted through the urethra, deposits are removed from the ureters and the renal calyco-pelvic system.
classic surgery. In the case of large stones, the kidney may need to be removed.
Underestimating the symptoms of urolithiasis can lead to serious complications. Currently, surgical procedures performed during the treatment of the ailment in question are safe and do not require hospitalization for several days. If a patient experiences the symptoms discussed above, he should contact a physician in order to assess his health condition and, if necessary, to choose a treatment method.

Source: