Stones in the urinary tract (urinary calculus) is hard as a rock mass formed along the urinary tract and can cause pain, bleeding, blockage of urine flow or infection.
These stones can form in the kidney (kidney stones) and in the bladder (bladder stones).
The process of stone formation is called urolitiasis (litiasis renal nefrolitiasis).
Cause Stone formation can occur due to urine saturated with salts that can form stones because urine or lack of normal inhibitors of stone formation.
Approximately 80% of stones composed of calcium, the rest contains various substances, including uric acid, cystine and minerals struvit.
Struvit stone (a mixture of magnesium, ammonium and phosphate), also called infection stones because these stones are formed only in the urine of infected.
Stone size varies, ranging from who can not be seen with the naked eye until a rate of 2.5 centimeters or more.
Large stone called staghorn calculus. This stone can fill almost the entire renal pelvis and renal kalises.
Symptoms
Stone, especially the small, could not cause symptoms. Stone in the bladder can cause pain in the lower abdomen.
Stones that obstruct the ureter, renal pelvis and renal tubules can cause back pain or renal colic (severe colic pain).
Renal colic is characterized by severe pain that relapsing-remitting, usually in the region between ribs and hip bones, which spread to the abdomen, pubic area and inner thighs. Other symptoms are nausea and vomiting, bloated abdomen, fever, chills and blood in the urine. Patients may be frequent urination, especially when the stones pass through the ureter. Stones can cause urinary tract infections. If the stones block the flow of urine, the bacteria will be trapped in the urine collected over the blockage, and thus infection. If the blockage lasts a long time, urine will flow back into the channel in the kidney, causing stress that will inflate the kidneys (hydronephrosis) and eventually kidney damage can occur.
Diagnosis
Stones that do not cause symptoms, may be found by accident on the examination of routine urine analysis (urinalysis).
Stones that cause the pain is usually diagnosed based on symptoms of renal colic, accompanied by a tenderness in his back and groin or pain in the pubic area without obvious cause. Microscopic analysis of urine may reveal blood, pus or a small rock crystal. Usually do not need another examination, unless the pain settled more than a few hours or the diagnosis is uncertain. Additional checks that can help make a diagnosis is a 24-hour urine collection and blood sampling to assess levels of calcium, cystine, uric acid and other substances that can cause stones. Abdominal X-rays may reveal calcium stones and stone struvit. Other tests that may need to do is urografi urografi intravenous and retrograde.
Treatment
Small stones that do not cause symptoms, blockage or infection, usually do not need to be treated. Drink plenty of fluids will increase urine output and help to remove some stones; if the stone has been lost, so do not need immediate treatment. Renal colic can be reduced with narcotic analgesics. Stones in the renal pelvis or ureter uppermost part of measuring 1 centimeter or less can often be solved by ultrasonic waves (extracorporeal shock wave lithotripsy, ESWL).
Fragments of stone will be dumped in the urine. Sometimes a stone removed through a small incision in the skin (percutaneous nephrolithotomy, percutaneous nefrolitotomi), followed by ultrasonic treatment. Small stones in the ureter the bottom can be removed with the endoscope is inserted through the urethra and into the bladder. Uric acid stones sometimes will dissolve gradually in the atmosphere of alkaline urine (for example by giving potassium citrate), but other stones can not be solved in this way. Uric acid stones are larger, which causes blockage, it should be removed surgically. The presence of stone struvit indicate the occurrence of urinary tract infection, because it was given antibiotics.
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