Who are at risk for stone formation?
Testesteron => increases oxalate synthesis and crystallization
Estrogen => increases citrate (prevents stone formation) excretion into urine
Is it related to food?
What are the harms of kidney stones?
Apart from the fact that kidney stones can cause severe pain, they can cause kidney obstruction, permanent loss of kidney function and kidney failure.
By laying the groundwork for infection, it may cause dysfunction of other organs and cause severe infections (urosepsis).
What can be done to prevent stone formation?
Regular physical activity, adequate fluid consumption and a balanced diet are quite important. If you have urinary system stones, it would be useful to get information from your physician about your nutritional habits. It is important to investigate the underlying metabolic causes in patients with recurrent stone attacks, and to have regular check-ups in patients who require medical (drug) treatment.
How are kidney stones diagnosed?
While symptomatic stones cause pain and refer the patient to the physician, asymptomatic (silent) stones are often diagnosed incidentally.
We use biochemical and radiological methods to make a diagnosis. Urine analysis, blood tests are performed when necessary and the imaging method is decided. Ultrasonography is the primary diagnostic method and its most important advantage is that it does not contain radiation and is easy to apply. However, its sensitivity is low (45%). That means, it may not be able to detect the existing stone. Ultrasonography is the first-line diagnostic method in pregnant women and children.
The most sensitive imaging for stone detection is non-contrast computed tomography. With low-dose stone protocols, computed tomography can be performed with radiation as much as a lung x-ray.
What are the treatment options for kidney stones?
It is not preferred in pregnant women, patients taking blood thinners, and patients with urinary tract infection, in the presence of obstruction in the urinary tract for some reason.
The hardness of the stone, the distance between the stone and the skin, the location and size of the stone in the kidney are factors affecting the success of the procedure.
Its biggest advantage is that it is performed without any incision in the body and the short hospital stay. In large-sized kidney stones, the possibility of complete purification from the stone is reduced.
In case the stones fill different calyces of the kidney, it may not be possible to reach all stones from a single tube, despite the flexible devices you have. In such cases, it may be necessary to make more than one entry to the kidney. This additional intervention decision is a decision that the surgeon will make during the operation according to his experience. At the end of the procedure, a tube (nephrostomy) is mostly placed in the patient’s kidney to ensure a safe flow of urine and to resolve edema.
The most important complication of the procedure is bleeding. Puncturing the kidney, which has a very dense blood supply, with a tube carries the risk of bleeding. But the structures around the kidney limit this bleeding in a short time. While blood transfusion is required in approximately 7% of patients after PNL operations; In 0.5%, bleeding that requires intervention occurs. This surgery is not performed when using the drug in patients with bleeding disorders or using anticoagulant or antiagregant drugs due to the risk of bleeding.
One of the important complications of this surgery is infection. Therefore, in patients with urinary tract infections, this surgery should be delayed and should be done after the infection is completely cured.
Despite all these, PNL surgery is one of the most reliable and effective treatment methods known today, especially for large stones.
What are the treatment options for ureteral stones?
Treatment for kidney stones with different anatomy?
In many congenital anomalies of the kidney such as horseshoe kidney, pelvic kidney, ectopic fusion kidney, kidney with rotation anomaly, the treatment of stone disease is special and experience is very important in the decision of treatment. In these patients, the most appropriate treatment option is applied according to the localization of the stone in the kidney, the localization of the kidney in the abdomen and the patient’s additional diseases.
Which stones should be treated?
If the ureter stones are large (stones larger than 1 cm are not expected to fall spontaneously, although there is no definite limit for a large definition), or if they completely obstruct the flow of urine, cause pain, have a single kidney or have stones in both ureters, surgical treatment is required for these stones. . In the presence of sepsis or pionephrosis (kidney filling with pus), after the infection treatment is completed by placing a stent (nephrostomy or ureteral stent), the stone surgery will significantly reduce the risk of the procedure.
If the kidney stone is large (> 2 cm), causes pain, obstructs urine flow, and if the kidney is anatomically / functionally affected, these stones should be intervened. The localization of the stone in the kidney, the shape and location of the kidney, and additional disorders of the patient guide us to decide apropriate surgical method.
Who should be investigated to detect the causes of stone formation?
Metaboic evaluation should definitely be performed in childhood stone patients, patients with recurrent stone history, patients with single kidney stones, family history, and patients with suspected hereditary stone disease.
Is there any drug treatment for stone disease?
Drug treatments have a place in stone disease. Although there are treatments (medical expulsive therapy) available to facilitate the fall of ureter stones in this area, there are also treatment methods (medical prophylaxis) used to reduce the risk of stone recurrence. Preventive treatment can be planned according to the underlying metabolic cause and stone analysis result.