Treatment options for urinary stone disease

Dr Sumit Mehta, a Consultant Urologist, and Andrologist, Hiranandani Hospital, Vashi, shares how to deal with the stone disease

Image source: Google
Image source: Google

These days, a common disease that is harassing the old and young alike, the young working population frequently getting diagnosed with urinary stones, resulting in loss of working days, productivity and increased morbidity.

Urinary stones are small, hard deposits of uric acid that form in kidneys, and are painful when passed in the urinary tract.

It has affected 10 per cent of the population and has had 30 per cent recurrence ratio in the past ten years. The disease affects both men and women from all age groups, starting at five years of age.

Some of the symptoms include:

Severe abdominal and flank pain which moves to the groin

  • Voiding pain and urinary symptoms of the poor interrupted urinary stream, or inability to pass urine
  • Fever and vomiting may be present
  • Sometimes Urinary Stone Disease (USD) is silent with no symptoms or just one attack of pain which disappears with medication
  • Pain may come back after long intervals of months or years. Usually, by then, irreversible kidney damage has occurred.

Causes

  • Reduced hydration
  • Predominant consumption of non-veg food
  • Consumption of extra salty food
  • Obesity
  • Sedentary lifestyle

Few tests are done when there is a suspicion of stone disease. The tests include a routine microscopic examination of the urine, blood counts, serum creatinine levels, blood sugar levels, an X-ray of the urinary passage, Ultrasonography, and a CT scan.

Treatment

Hydration, pain relief and medication are recommended to encourage small stones (less than 5mm in adults) to pass out. Antibiotics may be advised if there is an associated infection.

Scientific medicine does not have medication to dissolve stones, except in some patients with rare Metabolic Stone Disease. Medication is usually prescribed to encourage passage of stones painlessly.

It needs to be monitored with good follow-up. If the stones are damaging the kidneys or detrimental to the patient’s health, other modalities are recommended.

It may not always be related to stone size alone. These modalities include Extracorporeal Shock Wave Lithotripsy (ESWL), ureterorenoscopy (URS), Percutaneous Nephrolithotomy (PCNL) or Retrograde Intrarenal Surgery (RIRS).

Lasers are also used to break stones with precision along with all the above minimally invasive modalities. Other channels are Ultrasound, Pneumatic, and Electrohydraulic Lithotripsy.

Prevention

  • Adequate hydration
  • Salt restriction
  • A predominantly vegetarian diet
  • Avoiding specific food items to prevent the disease, except in Metabolic Stone formation, which is a rare disorder
  • A regular health check for stones goes a long way in early detection and treatment by non-invasive means