비뇨기질환
What are urinary stones?
This refers to stones that form in the urinary tract, which consists of the kidneys, ureters, bladder and urethra. The organs involved in producing and excreting urine are the kidneys, which make the urine; the ureters, down which it passes; the bladder, where it collects; and the urethra, through which urine stored in the bladder is expelled. Stones can form in any of these organs, and this is called urinary stone disease, classified by the location of the stone as kidney stone, ureteral stone, bladder stone or urethral stone. In Korea it is a common condition, affecting about 3% of the population. The incidence is 2-3 times higher in summer than in winter, it occurs mainly in people in their 30s to 50s, and it is about 1.5-2 times more common in men than in women.
Small stones Excreted in the urine
Large stones Blocks the ureter and causes various complications
Symptoms and complications of urinary stones
Most people have no symptoms, but some develop flank pain, and nausea, vomiting, hematuria and abdominal distension may occur. Microscopic hematuria is also often found on urinalysis. (Most urinary stones initially form in the kidney and then descend into the ureter or bladder, where they cause symptoms.) If a stone is left until it grows too large, it may adversely affect kidney function or later require major surgery.
Flank or lower abdominal pain, gross hematuria, nausea and vomiting may occur, along with bladder irritation symptoms such as frequent urination, a feeling of incomplete emptying and painful urination.
However, not all symptoms appear at once; if any one of the above occurs, a ureteral stone can be suspected.
(Without appropriate treatment it can cause pyelonephritis or irreversible damage to kidney function, so prompt treatment is required.)
Painful urination, difficulty urinating and frequent urination appear along with blood in the urine. When bladder stones are present, a prostate examination is sometimes needed because of the possibility of voiding dysfunction.
Causes of urinary stones
Urine normally contains various substances in solution, such as calcium, oxalate and phosphate. Usually these stay dissolved in the urine, but under certain conditions their concentration rises suddenly so that they can no longer dissolve and turn into small crystals; as these grow or merge, urinary stones form. The factors that make urinary stones more likely are as follows.
Genetic factors
Even without a specific genetic disorder, urinary stones run very strongly in families. If a parent has had urinary stones, their children are more likely to develop them.
Environmental factors
Urinary stones are common in regions with a hot living environment, because greater fluid loss concentrates the urine. Urinary stones occur more often in summer than in winter.
Fluid intake
When fluid intake is insufficient, urine volume falls and the stone-forming substances in the urine become more concentrated, so they can no longer dissolve and stones form.
Eating habits
Stones form more easily if you eat salty food or a lot of meat. Calcium intake makes no difference.
Treatment of urinary stones
| ESWL (Extracorporeal Shock Wave Lithotripsy) |
|---|
| A treatment that breaks up stones with shock waves from outside the body |
| URS (ureteroscopy) |
| A treatment that uses an Olympus 4K flexible endoscope to locate the stone directly, then break it up and remove it |
| PNL (Percutaneous Nephrolithotomy) |
| A treatment in which an endoscope is inserted through a small opening in the back into the kidney to break up and remove stones |
| Vesicolitholapaxy |
| A treatment in which a cystoscope is passed through the urethra to break up stones in the bladder and extract them |
Post-treatment precautions
- Treatment results and duration may vary depending on individual symptoms.
- Temporary side effects may occur after treatment and vary with each individual's condition.
