Stones in the urinary tract (urinary calculus) is a rock hard mass that forms in the urinary tract and can cause pain, bleeding, infection or blockage of urine flow.
These stones can form inside the kidneys (kidney stones) and in the bladder (bladder stones).
The process of stone formation is called urolitiasis (litiasis renal nefrolitiasis).
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Cause
Stone formation can occur because the urine is saturated with salts that can form bladder stones or because of water shortages normal inhibitors of stone formation.
Approximately 80% of calcium stones, the rest contains various substances, including uric acid, and minerals Sistin 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 can not be seen with the naked eye until a fee of 2.5 centimeters or more.
Large stone called staghorn calculus. Stone was able to fill almost the entire renal pelvis and renal kalises.
Symptom
Stone, especially the small, could not cause symptoms.
Stone in the bladder can cause pain in the lower abdomen.
Stone blocking 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 lost-emerged, 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, abdominal distention, 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, bacteria will be trapped in the urine collected over the blockage, so there was an infection.
If this blockage lasts a long time, urine will flow back into the channel in the kidney, causing kidney emphasis will be inflated (Hydronephrosis) and can eventually damage the kidneys.
Diagnosis
Stones that do not cause symptoms, it may be known by accident on the examination of routine urine analysis (urinalysis).
Stone that causes pain is usually diagnosed based on symptoms of renal colic, coupled with 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 crystal stones.
Usually do not need another examination, unless the pain settled more than a few hours or the diagnosis is uncertain.
Additional examinations that can help make a diagnosis is a 24-hour urine collection and blood sampling to assess the levels of calcium, Sistin, uric acid and other ingredients that can cause stones.
Abdominal x-rays may reveal calcium stones and stone struvit.
Other tests that may need to do is intravenous urography and retrograde urography.
Treatment
Small stones are not causing symptoms, obstruction or infection, usually needs no treatment.
Drink plenty of fluids will increase urine formation and helps remove some stones if the stone has been wasted, it is not necessary immediate treatment.
Renal colic can be reduced with narcotic pain medication.
Stones in the renal pelvis or ureter top section measuring one centimeter or less can often be solved by ultrasound (Extracorporeal Shock Wave Lithotripsy, ESWL).
Stone fragments will then be discarded in the urine.
Sometimes a stone removed through a small incision in the skin (percutaneous Nephrolithotomy, nefrolitotomi percutaneus), followed by ultrasonic treatment.
Small stones in the bottom of the ureter can be removed with the endoscope is inserted through the urethra and into the bladder.
Sometimes uric acid stones will dissolve gradually in the atmosphere of alkaline urine (for example by giving potassium citrate), but other stones can not be resolved in this manner.
Uric acid stones are larger, which causes blockage, it should be removed surgically.
The presence of stone struvit indicate a urinary tract infection, as it was given antibiotics.