Kidney Stone Disease. Advances in Urology

Subject: Urology
Pages: 3
Words: 869
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3 min
Study level: College

Kidney stones is a disease affecting the urinary tract. The medical term for kidney stones is renal calculi, urolithiasis or nephrolithiasis (Alelign & Petros, 2018). Kidney stones are generally described as hard crystalline objects that consist of chemicals in the urine. There are four types of renal calculi, and the difference is based on the primary chemical composition in urine that they were made from. These include uric acid, calcium oxalate, cystine and struvite (Alelign & Petros, 2018).

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Urine constitutes several types of waste dissolved in it; therefore, when the salts are in excess in the urine, the process of crystallization begins. Crystals continue to form and grow larger unless they are passed out of the body with urine. Kidney stones occur due to genetic factors, high salt and protein intake, dehydration, and vitamin B6 deficiency.

There are kidney stones of different sizes, and it is a general rule that the larger the stone, the more conspicuous the symptoms. Stones that do not cause any pain are often discovered when diagnosing unrelated conditions. Although they are present in the kidney, they do not interfere with urine flow (Alelign & Petros, 2018). On the other hand, those impeding urine flow are associated with pain, which is the primary presenting symptom. The pain is felt in the inguinal areas and the lower abdomen; furthermore, the severity of the renal colic varies from mild to extreme pain. In most cases, the patient is unable to find a comfortable position.

Another common symptom is blood in the urine that occurs in approximately 95% of the cases (Alelign & Petros, 2018). The blood can be detected by microscopic evaluation of urine or be visible to the naked eye. The patient can also experience vomiting and nausea, which is common when they are dehydrated. Once the stone reaches the location where the ureter drains into the bladder, the individual experiences an increasing urge to urinate frequently and a burning sensation during urination. This occurs due to the stone irritating the bladder. Finally, in the event that a urinary tract infection occurs, the patient experiences fever.

Diagnosis of kidney stones can be done using x-ray, CT scans or ultrasound. In approximately 70-80% of the cases, the stones are less than 6mm in diameter; therefore, treatment will focus on managing symptoms, such as pain, nausea and vomiting (Alelign & Petros, 2018). The treatment of kidney stones varies from simple interventions; for instance, small stones could be removed by drinking a lot of water to facilitate the dissolution of the crystals.

Conversely, if the stones are large, treatment like percutaneous nephrolithotomy, cystoscopic-ureteroscopic and extracorporeal shockwave lithotripsy (ESWL). In extreme cases, surgery may be required. ESWL is a technique used to disintegrate stones less than or equal to 2cm in the upper ureter or the kidney. It is regarded as an outpatient procedure and is performed under intravenous sedation. The location of the stone is identified, and a shock wave capable of penetrating the body and breaking the stone, subjected. After multiple shocks are given, the stone pulverizes, and the fragments passed out through urine in a few weeks.

Percutaneous nephrolithotomy is used in treating calculi larger than 2-3 cm. Sometimes stones present in the entire renal collecting system require both ESWL and percutaneous debulking. Percutaneous nephrolithotomy entails accessing the kidney through the flank using a guidewire passed down to the ureter. Under anesthesia, the tract is dilated, a scope inserted, and the stone clutched with a basket and removed. Alternatively, the stones can be fragmented using a laser, electrohydraulic lithotripsy or ultrasound, and then grasped and removed using the scope.

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Lastly, cystoscopic-ureteroscopic treatment is used to remove stones found in the mid to distal ureter. A scope is used to gain access to the bladder and the guidewire placed on the affected ureter. After that, the rigid ureteroscope is guided into the ureter and directs vision to the position of the stone. Similar to percutaneous nephrolithotomy, small stones are grasped using the basket and the large ones fragmented.

Medical terms are usually complex and have distinct clinical meanings. As a result, in most cases, patients find it difficult to comprehend the words, thereby misinterpreting the meaning. Although some words have been integrated into the normal vocabulary, there are still those that are unfamiliar. In the context of a medical practitioner interacting with a patient with kidney stones, several medical terminologies might crop up, and these are represented in the table below. They are in regards to the disease process, treatment parts of the body and symptoms.

Medical Word Layman Terms
Ureter A tube carrying urine from the kidney into the bladder
Bladder A hollow organ in the body that is used to store urine
Renal colic Stone Pain
Hematuria Blood in urine
Calcium oxalate, cysteine and struvite Mineral salt wastes in urine
Percutaneous nephrolithotomy An intrusive procedure that is used to remove stones larger than 2-3 cm
Extracorporeal shockwave lithotripsy An intrusive procedure that is used to remove stones less than or equal to 2cm in the upper ureter or kidney
Cytoscopic-ureteroscopic An intrusive procedure that is used to remove stones located in the middle of the ureter
Anesthesia A drug used to induce temporary loss of sensation.

Reference

Alelign, T., & Petros, B. (2018). Kidney stone disease: An update on current concepts. Advances in Urology, 1, 1-12. Web.