The Prostate

Urinary Tract Stones (Urolithiasis)

The urinary tract is a critical part of the body. It forms part of the renal system. The renal system consists of the kidneys, bladder, and the urethra, among other parts.

The kidneys help to remove toxins and waste materials from the body. The waste material is then sent to the bladder, along with excess fluids in the body. This helps to reduce toxins build up in the body.

Certain problems can affect the urinary tract, as well as the bladder and kidneys. When looking at the formation of stones and crystals, the kidneys are often the focal point. It is crucial to consider the fact that other parts of the urinary tract can also be affected by such stones.

Urolithiasis (uric acid kidney stones) is a concern where stones form in the urinary tract. Recent studies show an increase in the prevalence of Urolithiasis and related conditions.

We take a closer look at what Urolithiasis is in this post. We also consider how the diagnosis of the condition works. Furthermore, the post looks at the current treatment and prevention strategies.

What Is Urolithiasis?

We will start by taking a closer look at what Urolithiasis is. The condition refers to a process where stone forms. The entire urinary tract and the renal system can be affected.

This means Urolithiasis can cause stones to form in the urinary tract. Additionally, the condition also refers to stones that form in the bladder and kidney.

Among these, stones in the kidneys are generally considered the more common kind. Kidney stones are also considered a significant cause for blood to appear in a person’s urine. Several complications have been linked to Urolithiasis.

Patients are at a greater risk of a urinary tract infection. There are several factors involved in the formation of stones related to the condition. Patients should understand all the factors that contribute to Urolithiasis. This gives them a better understanding of what may have caused the formation of these stones. It also provides for a more effective approach to preventing the condition too.

When the condition goes untreated, there is a risk of ureteropelvic junction obstruction too2. This is considered a relatively serious urological condition.

How Is Urolithiasis Diagnosed?

Patients should understand how the diagnosis of Urolithiasis works. When symptoms are experienced, the person should seek an examination from a healthcare professional. When Urolithiasis is suspected, certain tests need to be performed.

One study explains that about 600,000 patients are diagnosed with Urolithiasis in an emergency department each year in the United States3. It should be noted that a diagnosis is not made through a physical examination alone. Certain imaging tests need to be performed.

A doctor will get a patient to undergo these tests. This is the case when the doctor does suspect Urolithiasis. The diagnosis process is generally the same regardless of where the stones have formed. This includes the kidneys and bladder. There are also cases where the urinary tract is affected.

Ultrasound is a rather standard diagnostic tool. Intravenous Pyrography is also sometimes used. This test is also referred to as IVP. There are some cases where a doctor would request a CT scan (Computed tomography) instead.

These imaging tests help the doctor see a visual image of the renal system. The presence of stones can be detected with the visual image. A doctor will only consider appropriate treatment once the presence of stones in the renal system has been confirmed.

What Causes Urolithiasis?

When looking at Urolithiasis, people should be aware of the causes behind the condition. The stones are formed due to the accumulation of certain substances. The substances build up in the renal system. In most cases, oxalate stones4 are found in the kidneys. These stones are caused by oxalate.

Oxalate is a natural compound. It is found in food that people eat every day. The oxalate is transferred through the bloodstream. Once it reaches the kidneys, the oxalate in the blood is removed. It starts to accumulate in the kidneys. It is later transported to the bladder.

When there is a deficiency of fluid in the kidney, the buildup of oxalate can cause stones to form. Sometimes, the accumulation of oxalate causes small crystals to develop. There are cases where the crystals start to stick together. In this scenario, the crystals may form a larger mass. The mass is generally referred to as a stone.

There is a strong association between diabetes mellitus and uric acid stone formation. It is proposed that uric acid urolithiasis may be added to the conditions that potentially are associated with insulin resistance.

Oxalate will generally stick to the calcium content in the kidneys too. This is what causes the formation of a calcium oxalate stone. While calcium oxalate stones are common, other compounds can cause these stones too.

Urolithiasis has also been linked to the following compounds:

  • Cystine

  • Phosphate

  • Xanthine

  • Urate

The collection of these substances can also cause crystals to form in the kidneys. The result can sometimes be a stone.

In most cases, stones are relatively small. This means they can be passed through urination. There are cases where stones become much more abundant. In such a case, passing them through the urethra may not be possible.

There are several factors that influence the ability to pass a stone. These include the size of the person, prior stone passage, prostate enlargement, pregnancy, and the size of the stone. 

What Is The Difference Between Nephrolithiasis And Urolithiasis?

Nephrolithiasis and Urolithiasis are two common terms used when a kidney stone develops. It is important to consider the differences between the terms. They do, however, sometimes refer to the same thing.

Urolithiasis is a term that refers to a stone that develops at any point in the urinary system. Nephrolithiasis, on the other hand, refers to a stone that forms in the kidney specifically. Thus, either Nephrolithiasis or Urolithiasis may be used when referring to kidney stones in particular.

Another name that may sometimes come up is ureterolithiasis. This is when calculus develops in the ureter. The same name may be used when the calculus has moved toward the ureter.

Symptoms Of Urolithiasis

The recognition of symptoms associated with Urolithiasis is crucial. This is primarily due to the fact that the condition can cause complications when it goes untreated.

There are times when a patient will not require medical treatment. This refers to scenarios where the stones are small. Large ureteral calculi and oxalate stones can cause problems.

In this section, we look at the symptoms a person should look out for. This ranges from metabolic abnormalities to signs specific to the region where the stones have formed.

Several symptoms can develop with Urolithiasis.

Urinary tract symptoms are prevalent. This is because the urinary system is directly affected by the presence of these stones. The crystals of uric acid may initiate calcium oxylate precipitation in metastable urine concentrates. Whether struvite stones or calcium oxalate stones have developed, symptoms will often be similar.

The location of the stones does count here. Ureteral stones may differ from kidney stones in terms of symptoms, for example.

  • During urination, only a small amount of urine may be expelled from the urethra at a time.

  • Many people find that their urine also produces a foul smell when they have Urolithiasis.

  • The urine may also seem cloudy.

  • Blood in the urine is also a very common symptom of Urolithiasis. In such a case, urine may have a red or pink appearance. Some people have reported a brown color in their urine too.

  • Pain is also common in people with Urolithiasis. The pain may affect various parts of the patient’s body. This includes the back and side regions of the body.

  • Some people experience abdominal pain too. Pain may radiate sometimes. The pain radiates between the grown and the lower region of the abdomen.

  • Some people may experience nausea. It is also possible that Urolithiasis may cause a patient to vomit.

How Severe Are The Typical Symptoms Of Urolithiasis?

The severity of symptoms depends on how serious the Urolithiasis is. Additionally, it is also important to consider possible complications that may come with the condition.

Larger stones are more likely to cause severe symptoms. This may include severe abdominal pain. The pain symptoms in the back and sides may also become severe in such a case. Pain may sometimes fluctuate in terms of intensity. It can be worse during certain periods. Other times, the pain may not be as severe.

One important complication that needs to be taken note of include infection. When the stone is too big to be passed through the urethra, there is a risk of infection. The infection can affect various parts of the urinary tract. This can lead to additional symptoms that signal an infection.

A fever can develop in the patient. Some patients may also experience chills. When no medical treatment is provided, there is a risk of the infection becoming more serious. In such a case, the severity of the symptoms may become escalated.

How Do You Diagnose Urolithiasis?

Self-diagnosis is never appropriate for Urolithiasis. Even when all symptoms match that of the condition, there are still other potential underlying factors.

A doctor is also unable to diagnose the condition with only a physical examination. Imaging tests are crucial to ensure an accurate diagnosis of the condition is made.

A patient should also avoid treating themselves for Urolithiasis. This is especially important if no diagnosis has been made yet. Other conditions can cause symptoms that are similar to Urolithiasis. Thus, all possible underlying factors should first be ruled out.

Treatment Options For Urolithiasis

Treatment is crucial for Urolithiasis. The appropriate treatment for the condition depends on certain factors.

A treatment that is appropriate for one patient may not work as well for another patient. Following the diagnosis of urinary stones, a doctor will be able to determine the best treatment route.

The doctor will consider all the factors involved. An important factor is the size of the stones in the urinary tract. The type of stones may also be taken into consideration.

The doctor also considers the location of the oxalate or struvite stones. Furthermore, risk factors for complications are taken into consideration. A doctor may also look at whether there is a ureteropelvic junction obstruction.

What Home Remedies Help Urolithiasis?

There are many cases where a doctor may prefer to wait before implementing treatment. This is generally the case when the urinary stones are very small.

Crystals can often be passed through the urethra. This happens while the patient urinates. In such a case, the doctor may prefer to possibly avoid more invasive treatment options.

When a patient is told to monitor their symptoms, there are a few home remedies that can be utilized. These home remedies may help them pass the stones faster.

Hydration is considered a key element. The formation of these stones has been referred to as a lack of adequate fluids. By staying hydrated, there will also be more fluids to move through the renal system. This may help to increase the chances of passing the stones.

Other strategies that people can also try include:

  • Adding some lemon to water may help to dissolve the smaller stones in the urinary tract.

  • Basil juice has also been shown to be helpful. This juice may help kidney stones break down. This makes them easier to be pushed out through urination.

  • Kidney bean broth might help with dissolving the stones too. Additionally, this broth improves the chances of flushing out the stones.

It is important to be cautious when using natural remedies. Apart from water, some potential side-effects come with long-term use of certain strategies—drinking basil juice every day for too long causes an increased risk of bleeding. A person may also experience low blood sugar and low blood pressure.

How Do You Treat Urolithiasis?

Medical treatment for Urolithiasis is sometimes needed. There are different options available that can help. A doctor will first need to obtain imaging tests from the patient. This allows them to determine the most effective medical treatment.

Sound waves are sometimes used. These waves may help to break up the stones that have formed. Extracorporeal shock wave lithotripsy is used in these scenarios. The vibrations of the waves are very strong. A session lasts for up to 60 minutes. The patient may experience moderate pain while undergoing this therapy.

Certain medicines may be helpful too. Alpha-blockers are sometimes used. This drug relaxes the ureter’s muscle. It could make passing the stone easier. The drug may also reduce pain associated with the passing of the stone.

Surgical procedures may sometimes be considered. Percutaneous nephrolithotomy is the most common surgery for the condition. A small incision is made in the patient’s back during the surgery. General anesthesia is also used.

How To Prevent Urolithiasis

Prevention should always be considered the preferred option. The development of urolithiasis7 can often be exceptionally unpleasant. The patient can also experience severe pain.

Preventing the condition reduces the risks of complications too. This means no need to worry about urinary hesitancy and other related symptoms.

Prevention starts by recognizing the risk factors. Several factors can contribute to the development of these stones. Cystine, oxalate, and citrate need to be considered. The individual risk factors should be taken into account too.

Hydration is considered a key element in preventing Urolithiasis. This helps to improve the function of the urinary tract. It also ensures there is not a deficiency in fluids in the renal system. When a person drinks too little water, the risk of Urolithiasis is increased.

Drinking pomegranate juice is also useful as a preventative strategy. The juice has been linked to improved kidney function. It can also help with the process of flushing out toxins from the body.

Conclusion

Urolithiasis is a relatively common condition that affects a worldwide population. The condition is classified by the formation of stones in the urinary tract. Symptoms can include abdominal pain and certain urinary tract problems.

Recognition of the symptoms is essential. Failure to obtain adequate treatment can lead to an increased risk of developing certain complications. Several treatment options are available. Patients should also realize that there are preventative strategies. These can help reduce the risk of Urolithiasis.

Sources

  1. Clinical Cases in Mineral and Bone Metabolism. (2008) Epidemiology of Urolithiasis: an update. [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2781200/
  2. Urology Care Foundation. What is ureteropelvic Junction Obstruction? [online] Available at:
  3. Emergency Nursing Journal. (2007) Diagnosis and Treatment of Urolithiasis. [online] Available at: https://journals.lww.com/aenjournal/Citation/2007/04000/Diagnosis_and_Treatment_of_Urolithiasis.3.aspx
  4. National Kidney Foundation. What is a calcium oxalate stone? [online] Available at: https://www.kidney.org/atoz/content/calcium-oxalate-stone
  5. Pediatric Nephrology. (2009) Clinical and metabolic features of Urolithiasis and microlithiasis in children. [online] Available at: https://www.ncbi.nlm.nih.gov/pubmed/19603196
  6. The Kaohsiung Journal of Medical Sciences. (2017) Surgical management of urinary stones with abnormal kidney anatomy. [online] Available at: https://www.sciencedirect.com/science/article/pii/S1607551X17300414
  7.  Radiopaedia. Urolithiasis. [online] Available at: https://radiopaedia.org/articles/urolithiasis

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