The first documented case of urinary stone disease was seen in an Egyptian mummy about 6000 years old. Since time immemorial, urinary tract stone disease has plagued mankind causing immense misery and suffering. Repeated stone disease is a well-known risk factor for Kidney failure. Without treatment, stones can recur in almost fifty percent of patients.
Why Do Urinary Tract Stones form?
There are many reasons of urinary stones formation. The main reasons are -
Climate – A hot dry climate favours stone formation
Low water intake
Obesity – A BMI more than 30 doubles risk of stone formation
Diet – A diet high in salt, oxalate and animal protein predisposes to stone formation
Infection- Repeated urinary tract infection can predispose to stone formation
Anatomical Anomalies – Abnormal anatomy of the urinary tract can lead to recurrent stones
Metabolic Abnormalities – Certain metabolic anomalies can lead to repeated stone formation
Drugs – Certain class of drugs can also lead to formation of rare type of stones
How to Identify Stone Disease?
Stone disease can present as pain over abdominal flanks, difficulty in passing urine, nausea with vomiting, blood in urine, occasionally fever with burning sensation while passing urine.
How to confirm Stone Disease?
Ultrasound is an excellent screening method. It has no radiation and is cheap.
Contrast CT Scan of the Urinary Tract is more accurate and gives more details of the Stone and anatomy.
This is used in the clinical setting for the acute stone pain. Antibiotics are given in case of infection and as preventive strategy for stone formation. Aggressive Medical Treatment is required to prevent stones.
In the past, Surgical treatment had very high mortality rates.
Harold Hopkins introduced the Rod lens system in 1959 and since then it has revolutionised the treatment of urinary tract stones. With better endoscopes and energy sources, the treatment of urinary tract stones has become simpler and many patients can be treated on day-care basis. The chances of residual stones has also decreased.
How to Prevent Stones?
How much water should I drink?
As a rough guide try to keep your urine colourless throughout the day; this equates to a urine output of at least 1.5 to 2 litres per day.
What should I drink?
Plain water is good. Water with Citrous fruit juice helps in preventing stones. Tea and coffee can be taken in moderation. Black tea should be avoided by recurrent stone formers. Replace all lost fluid. Make sure that you keep yourself well hydrated.
Do I need to modify my diet?
Diet also contributes to your risk of stone formation. A balanced diet with adequate amount of fibre and vegetables should be taken. Meat consumption should be restricted to less than 100 grams. Recurrent stone formers should take less salt and food rich in oxalates like spinach, strawberries and tomato seeds. A moderate intake of Calcium is encouraged to prevent stones. Calcium absorbs excess oxalates in the gut.
Do I need to lose weight?
Yes. Obesity is a significant risk factor for stones.
Do I need to treat infection?
Yes! Infection leads to rapid recurrence of urinary stones.
Is there a need for Metabolic Evaluation?
Yes. In high risk stone formers two 24 hour urine specimens are analyzed for biochemical anomalies. If the stone is available then Stone analysis can also be done.
DR ALOK KUMAR JHA
Head of Department and Sr. Consultant Urology
OPD Timings : Mon-Sat 10, 10 AM-5PM
QRG Health City, Sector 16, Faridabad