Urinary stones are very common and in tropical countries like India, the incidence being as high as 10 % while in middle eastern countries it can go up to even 25%.
The most common stone in the urinary tract is made of Calcium Oxalate. Stones form mostly in the kidneys and occasionally in the bladder. These stones initially form as calcium oxalate crystals but then aggregate together, taking the shape of microliths, slowly enlarging into larger stones. When they fill the entire kidney, they are called staghorn calculi.
Stones may not cause any problems when in the kidney, but they sometimes drop down into the tubes that drain urine, called ureter. When in the ureter, these stones cause severe pain on one side of the lower back radiating down to the groin area. This can be excruciating pain and become unbearable in no time.
Treatment Of Stones In The Ureter
In many cases, small stones may pass in the urine by itself, but larger stones need treatment. The latest advancement is using a holmium laser through which the stones can be broken down to dust that enables complete treatment with minimal injury to the ureter.
Treatment Of Stone In The Kidney
Small stones in the kidneys were earlier treated through a procedure called PCNL which involves puncturing the kidney. This can have complications and can be painful. But the experts today use a special camera called Flexible ureteroscope which enables using a laser to treat small stones in the kidneys with minimal discomfort. The patient would require a minimum stay at the hospital and can resume normal duties almost immediately.
For larger stones, in place of the conventional PCNL, a mini PCNL is done as it causes less pain and leads to a quicker recovery.
Prevention Of Stones
About half of the patients who have had stones can face a similar problem within 10 years’ time. To prevent the further formation of stones, the doctor would recommend stone analysis, 24- hour urine analysis to find out the root cause. Once, the exact reason is established, the patient would be given recommendations about the dos and don’ts to prevent further formation of stones.
- Dr. Suresh Radhakrishnan, MBBS, MS (Gen), MRCSEd, MD (Uro-Oncology), FRCS (Urol), CCT(UK) is a Senior Consultant, Urology, Dr. Rela Institute & Medical Centre, Chennai
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