KIDNEY & URETERAL STONES

Stone disease is among the most painful and prevalent urological disorders. More than a million kidney stone cases are diagnosed each year with an estimated 10 percent of Americans destined to suffer from kidney stones at some point in their lives.

The incidence of urolithiasis, or stone disease, is about 12% by age 70 for males and 5-6% for females in the United States. Additionally, the gender gap may be decreasing as more women are being diagnosed and treated for kidney stones. The reason for the change is of the dietary and climate changes in our population. The debilitating effects of kidney stones are quite substantial, with patients incurring billions of dollars in treatment costs each year.

Fortunately, most stones pass out of the body without any intervention. If you are not so lucky, the following information should help you and your doctor address the causes, symptoms and possible complications created by your kidney stone disease.

What are stones and the difference between kidney stones and ureteral stones?

Normally, urine contains many dissolved substances. At times, some materials may become concentrated in the urine and form solid crystals. These crystals can lead to the development of stones when materials continue to build up around them, much as a pearl is formed in an oyster.

Stones formed in the kidney are called kidney stones. Ureteral stone is a kidney stone that has left the kidney and moved down into the ureter.

The majority of stones contain calcium, with most of it being comprised of a material called calcium oxalate. Other types of stones include substances such as calcium phosphate, uric acid, cystine and struvite.

Stones form when there is an imbalance between certain chemical urinary components such as calcium, oxalate and phosphate. These chemical components either promote crystallization while others inhibit it.

The most common stones contain calcium in combination with oxalate and/or phosphate.

A less common type of stone is caused by infection in the urinary tract. This type of stone is called a struvite or infection stone. Much less common are the pure uric acid stones. Much rarer is the hereditary type of stones called cystine stones and even more rare are those linked to other hereditary disorders.

What are the symptoms of a kidney stone?

Once stones form in the urinary tract, they often grow with time and may change location within the kidney. Some stones may be washed out of the kidney by urine flow and end up trapped within the ureter or pass completely out of the urinary tract. Stones usually begin causing symptoms when they block the outflow of the urine from the kidney leading to the bladder because it causes the kidney to stretch.

Usually, the symptoms are extreme pain that has been described as being worse than child labor pains. The pain often begins suddenly as the stone moves in the urinary tract, causing irritation and blockage. Typically, a person feels a sharp, cramping pain in the back and in the side of the area of the kidney or in the lower abdomen, which may spread to the groin.

Sometimes a person will complain of blood in the urine, nausea and/or vomiting. Occasionally stones do not produce any symptoms. But while they may be “silent,” they can be growing, causing irreversible damage to kidney function. More commonly, however, if a stone is not large enough to prompt major symptoms, it still can trigger a dull ache that is often confused with muscle or intestinal pain.

If the stone is too large to pass easily, pain continues as the muscles in the wall of the tiny ureter try to squeeze the stone along into the bladder. One may feel the need to urinate more often or feel a burning sensation during urination. In a man, pain may move down to the tip of the penis. If the stone is close to the lower end of the ureter at the opening into the bladder, a person will frequently feel like they have not fully completed urination.

Stones as small as 2 mm. have caused many symptoms while those as large as a pea have quietly passed. If fever or chills accompany any of these symptoms, then there may be an infection. You should contact your urologist immediately.