The usual stones in the urinary tract consist of calcium oxalate or calcium phosphate (or combined with ammonio-magnesium phosphate), or uric acid, etc. However, the stones may occur as a combination of these constituents, called ‘mixed stones’.
What are the symptoms of urinary stones?
Stone/s in the urinary tract may remain symptom less for long, and may be detected by routine X-rays. Stones which are stagnant/motionless in any part of the urinary tract do not show symptoms, although they may cause massive harm, as they grow in size. However, there is very severe pain (renal colic) as the stone starts moving downward.
A renal colic pain usually subsides with the administration of a strong pain-killer injection. Blood may also pass in the urine during an attack of renal colic, as a result of some injury in the urinary tract, caused by stones. Infection will also occur in the urinary tract due to the slowing down of the flow of urine. In which case pus cells will also be seen in the urine, when examined under the microscope.
What should be done for urinary stones?
It is advisable that the treatment of urinary stones is done in the earliest possible time after the acute attack has subsided, so that UTI is prevented. If neglected, besides causing repeated attacks of renal colic, the obstruction in the urinary tract will grow due to the increase in the size of the stone, which may show serious consequences later.
Small and early stones, causing little/no obstruction are usually pushed down and out, when the patient takes plenty of fluids, at least 3 litres of water per day.
In case the stone is not ejected, it must be removed either surgically, or by lithotripsy.
Lithotripsy is a non-surgical method of removing stones from the urinary tract. It is called extracorporeal shock-wave lithotripsy (ESWL), and in this procedure electrically generated shock-waves are focused on the stone and fragment it. Hence this mode of non-surgical therapy is ideal as it excludes surgery and late complications.
What tests are required in a case of urinary stones?
Tests like plain X-ray as well as ultrasonography of the urinary tract are important in order to detect the exact location of the stone, and to see the extent of damage caused to the urinary tract by the stone/so However, uric acid stones are not picked up in X-rays. Therefore, an intravenous pyelography may be required in some of the cases, to prove the presence of stones in the urinary tract. Intravenous pyelography is also useful in locating any associated lesion/ s of the urinary tract, such as a stricture, horseshoe kidneys etc.
The above tests should not be forgotten in a case of UTI for excluding urinary stones, especially when the patient has no signs/symptoms of renal colic.
It is essential that the stones once passed out or removed must be analyzed regarding their constituents, so that appropriate steps can be taken so as to avoid a recurrence of the stones. A restricted diet should be prescribed, depending on the stone analysis report.
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