Urinary Stones

Overview

People living in hot tropical climates are more prone to have urinary stones. Patients who suffer from urinary stones may have the following symptoms:

  • Abdominal, flank or loin pain
  • Blood in the urine
  • Urinary tract infection

Sometimes the stones are detected incidentally during health screening.

Symptoms

Pain
The pain experienced by patients suffering from stones can range from a mild ache to excruciating pain.

Recurrent urinary tract infection
Patients may complain of fever, feeling of being unwell, burning pain when passing urine.

Kidney damage
Stones can obstruct the urinary system and this leads to accumulation of urine within the kidneys. The kidneys may swell up causing a condition known as hydronephrosis. As a result the kidney function may deteriorate.

Treatments

The following are treatment options for urinary stones:

Medical therapy
If the stone is small enough, sometimes the body may pass it out on its own, with the aid of medication

Extracorporeal shockwave lithotripsy (ESWL)
Shock waves are focused onto the stone, which breaks into smaller pieces which can be passed out on their own. The procedure is not invasive and often hospital stay is not required.

Ureteroscopy and laser lithotripsy
A fine instrument called the ureteroscope is inserted into the urinary passage leading up to the stone. The stone is broken into smaller pieces with a laser and the fragments can be retrieved. The procedure requires general anaesthesia.

Percutaneous nephrolithotomy (PNCL)
A small incision is made in the skin, after which a tract is created to the kidney, for the insertion of an instrument called the nephroscope. The stone is broken into smaller pieces with high-frequency ultrasound or laser and the fragments can be retrieved. The procedure requires general anaesthesia.

Open surgery
A large incision is made, through which the stone is removed. This is seldom necessary in this day and age of minimally invasive techniques, and is usually performed only if the stone is very large and complex.

What can we do to prevent stones from forming?
Stones recur in up to 50% of patients. Blood and urine tests can be performed to check for factors that lead to stone recurrence. The diet should be modified if necessary to reduce the risk of recurrence. The following dietary advice is recommended:

Drink enough water – An adequate fluid intake is important as it prevents the stones from crystallising in the urinary system. In general, patients should drink enough water to make their urine clear and colourless.

Reduce salt intake – too much sodium can lead to formation of stones

Cut down on intake of foods that may cause stones – such as nuts, chocolates and tea (these foods are rich in oxalate)