This book describes Urinary Stones, Diagnosis and Treatment and Related Diseases

The pain of a urinary stone stuck in the ureter (the tube from the kidney to the bladder) is so severe that it has been described as second in severity to pregnancy labor pains.

The pains are usually down the flanks of the abdomen and accompanied by blood in the urine.

Drinking lots of water usually clears the stuck urinary stone.

An X-ray of the abdomen (preferably after passing the feces) will usually show the presence of the stone in 80% of the cases.

Recently I had a patient with a severe right back pain that traveled all the way down to the groin.

There was no blood in the urine but she had frequently passing of urine.

An X-ray of the abdomen showed enlarged right kidney but no evidence of a urinary stone.

The left kidney was normal.

There was definitely a blockage of the urinary tract causing backflow of urine up to the right kidney.

I gave her a painkiller and antibiotic to relieve her pain and sent her for an MRI of the abdomen to exclude the cause of the urinary obstruction on the right side,

The MRI confirms my suspicion of a urinary stone stuck at lower part of the ureter (the tube connecting the kidney to the bladder).

I have at least 1 patient every year with this condition.

All that is needed to prevent this pain and stone is by drinking lots of water (2-3 liters) a day.

Urinary Stones are small, solid masses made of crystals which happen when salts or minerals in the urine become solid crystals inside the kidney.

Urinary stones normally begin in the kidneys, pass down the ureter, bladder and out through the urethra.

Urinary stones are one of the most painful medical disorders.

Urinary Stones are formed normally due to the accumulation of salts and minerals particularly calcium in the urine.

At the same time, the urine may have inadequate substances that prevent crystals from sticking together, producing an ideal environment for urinary stones to develop.

Normally the stones may be so small that they pass out through the urine without the patient knowing.

Some become bigger due to accumulation of the salts and minerals and the concentration of the urine.

The bigger stones may stay in the tubes of the kidney and are termed renal stones.

Some smaller stones may move out of the kidney and passes through the ureters which are the tubes bringing urine from the kidney to the bladder.

These are termed ureteric stones.

If a ureteric stone gets stuck in the ureter, this can induce blockage of the urine and severe pain (urinary colic).

1. Calcium stones forms the most frequent (about 80%) of the urinary stones.
   
   a. Calcium oxalate: envelope or dumbbell-shaped
   
   b. Calcium phosphate: amorphous, wedge-shaped prisms in rosettes


2. Uric acid: rhomboid shaped


3. Struvite stones (infection stones) are produced when there is too much ammonia in the urine mostly in urinary tract infection; normally large and have a horn-like shape


4. Cystine: hexagon-shaped; yellow and crystalline

Symptoms:

1. Severe, sharp pain in the flank and the back, just below the ribs


2. Pain that radiates to the lower abdomen and groin


3. Pain that happens in waves and varies in intensity


4. Pain or burning sensation while urinating

Other signs and symptoms may be:

1. Pink, red or brown urine


2. Cloudy or foul-smelling urine


3. A persistent need to urinate, urinating often or in small amount


4. Nausea and vomiting


5. Fever and chills if an infection


6. Pain caused by a urinary stone may alter, shifting to a different site or rising in intensity as the stone travels through the urinary tract.

Analysis of passed stones is essential for diagnosis and treatment

TABLE OF CONTENT

Introduction

Chapter 1 Urinary Stones

Chapter 2 Causes

Chapter 3 Symptoms

Chapter 4 Diagnosis

Chapter 5 Treatment

Chapter 6 Prognosis

Chapter 7 Hematuria

Chapter 8 Cystitis

Epilogue