What is stone disease?
Kidney and urinary tract stone disease is a very common condition in daily Urology practice. This is a disease in which pain is at the forefront. Kidney stones occur when salt and minerals in your urine form crystals. The formed stones either remain silent in the kidney or fall into the urinary tract, also called the “ureter”, and are excreted. When it gets stuck in the urinary tract and blocks the flow of urine, it causes unbearable pain.
How common is stone disease?
Its incidence is 5-10%. Our country is in a region where urinary system stone disease is common. It is usually seen in people in their 30s and 40s and more often in men. Once seen, the frequency of recurrence is above P. Recurrence is observed in one-third of patients in the first year. Due to familial predisposition, the risk is higher in those with a family history of kidney stones.
What kind of complaints does stone disease cause?
The most common complaint is pain. However, depending on the size, shape and location of the stone, there may be no pain at all, or it may be excruciating and painful that oral painkillers do not work. The pain, which can hit the waist on the side under the ribs, is in a wavy and position-changing style that we call “renal colic”. This pain, which is likened to birth pain, can hit the groin if the stone is stuck in the urinary tract and can even be felt in the testicles in men. Other complaints that may occur are; These can include nausea, vomiting, fever, erectile dysfunction and painful urination. Renal colic is an emergency and requires contacting a healthcare provider as soon as possible. If there is fever, urgent intervention may be required.
What diseases and conditions can it be confused with?
Some kidney stones may not cause pain or other complaints. It may be discovered incidentally during a routine check-up or during ultrasonography performed for another reason. Differential diagnosis includes gallstones, appendicitis, infection, which may cause pain. Many diseases such as intestinal disorders and herniated disc should come to mind.
How is kidney stone treated?
Stone disease can largely be diagnosed with a careful medical history and physical examination. Initial evaluation is made with urinalysis and ultrasonography. If the stone falls into the urinary tract and causes obstruction; Your doctor can detect swelling in the kidney on ultrasound. The exact location, shape and size of the stone is determined by drug-free urinary system computed tomography (CT). The hardness of the stone is also determined with this technique, which uses low doses of radiation. This information is useful in treatment planning. If your doctor deems it necessary, intravenous medication may be administered during CT to obtain information about kidney function and anatomy. In addition, the presence of infection and kidney functions are investigated through urine and blood tests.
How is kidney stone treated?
For stones that are likely to pass spontaneously, a reasonable period of time can be expected with painkiller treatment, fluid intake and physical activity. Roughly speaking, the probability of spontaneous passage of stones under 5 mm is p. In stones larger than 7 mm, active intervention is usually required. Similarly, early treatment may be necessary in the presence of severe pain, special occupational conditions, a single kidney, and the presence of serious infection.
How are kidney and urinary tract stones treated?
When you come to our clinic with a diagnosis or suspicion of stone disease, your diagnosis is made through imaging after a careful evaluation. Since not every kidney stone requires treatment, recommendations and control timing for stones that are likely to pass spontaneously are determined by UROPARK physicians. For stones that cause large and severe pain; UROPARK physicians share active treatment options with you in detail. In general, it is useful for patients to know the following issues:
* The closer the stone is to the bladder, the more likely it is to pass.
*The larger the stone, the lower thelikelihood of spontaneous falling.
*In the treatment and follow-up program where the probability of spontaneous remission is very low and in cases where complaints increase.
*When there is a possibility of renal dysfunction
In active treatment planning, the following treatment methods are discussed with you in detail and the decision is made together. Frequently applied treatment methods can be listed as follows:
1-ESWL (shock wave therapy through body teeth): In this treatment, stones of a certain size and certain hardness in the Pelli area can be broken with sound waves given from outside the body.
2-Ureterorenoscopy (URS): In this technique, the stones in the entire urinary tract, including the kidney, are entered through the urinary tract with an imaging system and broken with laser energy.
3-Percutaneous nephrolithotomy (PCNL): In this operation, kidney stones of 2 cm or more are entered into the kidney with the help of a tube placed through the skin, and the stone is broken down in the kidney and taken out in small pieces.
After treatment of stone disease, metabolic evaluations should be performed in addition to stone analysis to reduce the risk of stone recurrence.
In metabolic evaluation, blood analysis is performed and 24-hour urine is collected and various substances in it are evaluated.
