Urinary Stone Disease

Causes

  • NO KNOWN CAUSE IN OVER HALF OF THE PATIENTS
  • METABOLIC DISORDER
  • HYPERPARATHYROIDISM
  • URINARY TRACT INFECTION
  • URINARY TRACT OBSTRUCTION
  • IMMOBILE PATIENT


Problems Due to Stone

  • PAIN
  • NAUSEA & VOMITING
  • PASSAGE OF BLOOD IN URINE (HAEMATURIA)
  • DIFFICULTY OR PAIN DURING MICTURITION (DYSURIA)
  • MAY BE 'SILENT' WITH NO PAIN


Types of Stones

  1. CALCIUM OXALATE
  2. CALCIUM PHOSPHATE
  3. URIC ACID
  4. TRIPPLE PHOSPHATE
  5. MIXED


Common Locations of Stone





Investigations




  • URINALYSIS
  • RENAL FUNCTION TEST (BLOOD UREA, S. CREATININE)
  • PLAIN X-RAY ABDOMEN
  • INTRAVENOUS UROGRAPHY
  • ULTRASOUND
  • CT SCAN


Treatement

  • ENDOSCOPIC TECHNIQUES
    • STONE EXTRACTION WITHOUT MAJOR SURGERY
    • ALMOST INVISIBLE SCAR
    • EARLY RETURN TO WORK

  • LITHOTRIPSY
    • NO CUTTING
    • PAINLESS
    • PATIENT GOES HOME SAME DAY

  • OPEN SURGERY


  • NEWER TECHNIQUES


Prevention

  • GENEROUS INTAKE OF FLUID & AVOID EXCESSIVE FLUID LOSS
  • FOODS TO BE AVOIDED
    • CHEESE
    • MEATS, FISH, FOWL
    • VEGETABLES: SPINACH, TOMATO TURNIP GREEN
    • FRUITS: RHUBARB
    • WHOLE GRAIN BREAD, BROWN & WHITE RICE
    • BEVERAGES: CARBONATED SOFT DRINKS, COCOA
    • MISCELLANEOUS: NUTS, PEANUT, CHOCOLATE

  • CONTROL OF INFECTION
  • CHANGE IN THE BODY POSITION OF IMMOBILE PATIENT
  • REGULAR CHANGE OF INDWELLING TUBES LIKE FOLEY CATHETER, JJ STENT.