Although there are many theories regarding the formation of urinary system stones, today it is believed that they occur due to the combination of many factors. These factors are: hormonal changes, environmental factors, nutrition, anatomical disorders, chronic infections, and some genetically transmitted diseases.
SYMPTOMS: Stones that do not cause any obstruction in the urinary system are usually diagnosed incidentally during an x-ray or ultrasonography (USG). Stones that obstruct the flow of urine and cause blockage in the duct cause symptoms such as pain in the flank, bleeding in the urine, fever, nausea and vomiting. The urinary duct (ureter) is an organ with an inner diameter of (0.3 - 0.5) cm and a length of 25-30 cm. Small stones are these. They pass through the duct and reach the bladder and are excreted from there. Larger stones get stuck anywhere in this canal and they apply to emergency services with pain and other symptoms. Pain is the most severe pain after myocardial infarction and causes panic in the patient and their relatives.
LABORATORY FINDINGS: Urinalysis may show signs of bleeding and infection. If there is bilateral urinary tract obstruction, high urea may be present.
X-RAY FINDINGS: Since most of the stones have high calcium content, they are noticed on x-ray. Other diagnostic methods are USG, IVP, tomography.
TREATMENT: Small stones that do not cause obstruction in the urinary tract usually pass spontaneously with medical treatment and plenty of fluid intake, which constitute 50% of all stones. It constitutes 60 of them.
Treatment methods followed for larger stones:
ESWL (Breaking with Shock Waves): Stones are broken down with shock waves given from outside the body. Some hard stones cannot be broken with this method. The stone breaking process may take several sessions. Broken stones sometimes fall and block the urinary tract, then alternative treatment methods are applied to them. This method has a low success rate in ureteral stones
Percutaneous Nephrolithotomy: 1cm. It is a method applied to stones larger than 1.5 cm through a tube by entering the kidney. The stones are broken by ultrasonic or pneumatic means, if necessary, a drain called nephrostomy is placed in the kidney.
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Rigid or Flexible Ureterorenoscopy; With this method, kidney and ureteral stones are broken by using laser when necessary, and after the procedure, a catheter called DJ catheter is placed in the ureter, allowing the stone fragments to pass more easily.
Nephrectomy. and Partial Nephrectomy; Depending on the damage caused by stones in the kidney, the kidney can be removed completely (nephrectomy) or partially (partial nephrectomy).
METABOLIC TREATMENT AND DIET IN STONE DISEASE:
a)If there is hyperparathyroidism among the causes of stone disease, it should be treated by endocrine and surgical means.
b)If there is high uric acid, this diet should be treated with medication if necessary.
c)If the level of citrate in the urine is low, K-Citrate must be added to the treatment.
d)If there is an infection in the urine, it must be treated.
e) Daily fluid intake should not be less than 1.5-2lt, this amount should be increased depending on environmental factors.
f) Weight should be lost and salt intake should be reduced.
g) Food should contain reasonably balanced meat, vegetables and fruit, and citrus fruit consumption should be increased in winter.
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