How are stones formed?
When the concentration of certain substances like Calcium, Oxalate, Uric Acid and Cystine are high in urine, they form crystals which attach to the kidney and gradually increase in size to form a stone.
What are the types of stones?
80%of stones are Calcium stones, mostly calcium oxalate and few calcium phosphates.
Rest of them are – uric acid stones, Infection stones and Cystine stones.
Risk Factors for Stone Formation:
Depends on the size and location of the stones.
The most common symptom caused by stones is pain in the flank or lower abdomen which may move to the groin. Pain is most common when passing a stone. Waves of severe excruciating pain are called ‘renal colic’ and last for 20-60 minutes.
There may be difficulty in urination, blood in urine or vomiting.
Gravel/sand may be passed in urine.
The stone may remain in the urinary tract and obstruct the flow causing pain.
Small stones in the kidney which do not cause obstruction may cause no symptoms at all.
Renal stones are diagnosed by ultrasonography or CT scan. X-Ray and intravenous pyelography are also useful modalities.
CT scan is more accurate but exposes the patient to radiation.
To know the type of stone, a 24-hour urine estimation of calcium/oxalate/uric acid and citrate is essential.
A urine examination is helpful to see if there is any infection or if the urine is acidic or alkaline.
Treatment of stones depends on the size and location of stone in the urinary tract.
Those less than 5mm usually passout without specific treatment. An increase in fluid intake and pain medications are required.
Severe episodes of renal colic require hospitalisation and treatment with intravenous fluids and other drugs.
Larger stones i.e. more than 9mm may require surgical removal, by percutaneous nephrolithotomy or Shock-wave lithotripsy.
Approximately 10-20 % of all stones require surgery.
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