Kidney stones

Article written by Doctor of Urology Department, Vinmec Central Park International General Hospital

Kidney stones are a common disease, can cause pain when moving down the ureter causing obstruction. The disease has very obvious symptoms and is easy to diagnose. Therefore, as soon as unusual pain appears in the back, spreading to the anterior abdomen, under the ribs and down to the groin, you should go to the doctor immediately for treatment when the new stone is small in size.

Kidney stones are very common, accounting for about 10% of the population. The disease is caused when the concentration of certain substances is too much in the urine than normal. These substances are deposited to form crystals, the main component of stone formation. Calcium stones combined with oxalates or phosphates are the most common. There are also other types of stones such as uric acid stones, struvite (infectious stones), cystine and some other rare stones.

There are many factors involved in urolithiasis but the main contributing factor is dehydration. Concentrated urine increases the formation of crystals from stone-forming substances. Other risk factors include family history of stones, diet, bowel disorders, obesity, and occupation. Diets high in protein, salt, or foods rich in oxalates (green leaves, seeds, tea, and chocolate) increase the risk of stones. Certain intestinal diseases such as inflammatory bowel disease, malabsorption, chronic diarrhea, and gastric bypass surgery.
When stones grow, they can obstruct the flow of urine or when stones move down to block the ureter. In some cases, kidney stones are a breeding ground for bacteria that cause recurrent UTIs.

Kidney stones are often discovered incidentally during routine ultrasound examinations. However, stones can also cause pain as they travel down the ureter (the tube that carries urine from the kidney to the bladder) causing an obstruction. The most common symptom is back pain. Pain radiates from the back to the anterior abdomen under the ribs and down to the groin. Severe pain can cause nausea, vomiting and the patient cannot find a position to relieve pain.

Patient may have hematuria (red blood cells in the urine) or painful urination. Stones that cause obstruction and are accompanied by fever are emergency situations that need to be treated early.

Diagnosing kidney stones is very simple. A history of renal colic in the flanks was noted, with no particular precipitating factor. There is often blood in the urine. Diagnosis is based on urinary tract imaging. Non-contrast computerized tomography (CT Scan) is the most accurate diagnostic tool. Renal ultrasound can be used to identify obstruction and may also detect stones. Blood and urine tests to assess infection and kidney function.

Most kidney stones less than 5 mm in size can pass spontaneously. Stone size is determined by imaging. When the stone is stuck in the ureter, the patient will be given medication by the doctor to help expel the stone, avoiding the need for surgical intervention. If the stone is large or cannot pass on its own after a period of drug treatment, surgery is required. Based on many factors, one of the following surgical methods can be chosen to treat stones such as:
Extracorporeal lithotripsy: using focused pulse waves to break up stones. The broken stones will move through the urinary tract out of the body. Laser retrograde endoscopic lithotripsy : use a rigid or flexible ureteroscope to view the urinary tract from the urethra, bladder, ureters and renal pelvis for lithotripsy with laser Percutaneous nephrolithography : create a path into the kidney through a small cut in the skin of the back. Thereby, a nephroscope is inserted into the kidney to dissolve the stone and remove the stone. Open surgery when the above measures fail, there are anatomical abnormalities of the kidney or when bacteriuria is present.

When the kidney stone is small and can be removed, it is advised that the patient drink a lot of water. Some medications can help get rid of stones. Pain relievers should be given early before the pain becomes severe because the pain may occur several times until the stone is expelled.
If the patient cannot eat or drink due to vomiting, the patient should be hospitalized for monitoring and treatment. In some emergency situations, a temporary ureteral or renal catheter is placed in the body to clear the blockage. In this situation, the stone may not be treated at the same time.
Based on risk factors, stone composition, and other necessary tests, the patient may be given certain medications to reduce future stone formation. All patients with urolithiasis should drink plenty of fluids to maintain urine output of 2 liters or more per day. Patients should limit the amount of salt, animal meat and oxalate-rich foods in their diets, and consume a moderate amount of calcium. Do not ban calcium, even patients with stones with calcium carbonate unless the doctor advises this because it can increase the risk of stone formation.
To detect kidney stones early, you should check your general health regularly. Currently, Vinmec International General Hospital has general health checkup packages suitable for each age, gender and individual needs of customers with a reasonable price policy, including:
Health checkup package general Vip Standard general health checkup package Patient's examination results will be returned to your home. After receiving the results of the general health examination, if you detect diseases that require intensive examination and treatment, you can use services from other specialties at the Hospital with quality treatment and services. outstanding customer service.