Urinary stones can be explained as the accumulation of minerals in any part of the urinary tract. According to their location, they are called kidney stones, ureteral stones, or bladder stones.

How are kidney stones formed?

Kidney stones may be formed for many reasons. When the concentrations of crystal-forming substances such as calcium, oxalate, and uric acid increase in the urine, these substances form precipitation and these precipitated minerals combine to form stones, just as in nature.

What are the types of kidney stones?

There are various types of stones with different chemical structures. Urinary system stones get different names according to these substances that make them up. These are:

  • Calcium stones,
  • Uric acid stones,
  • Cystine stones,
  • Struvite stones, and

other stones different from these common stone types.

Some stones may contain several chemical structures at the same time.

Is it possible to determine the type of kidney stone?

The type of kidney stone and the risk of a person for developing stones can be determined. With a metabolic evaluation and the analysis of the stone, removed by surgery or dropped naturally, it is possible to determine the risk. The formation of the stones can be reduced by regulating eating habits and, if necessary, by drug supplementation.

What are the symptoms of stone disease?

Kidney stones may be present in the kidneys with no symptoms for many years. When these stones move and fall into the ureter (urinary tract), they may cause quite severe symptoms and a hard situation. These symptoms include:

  • Severe flank pain under the ribs
  • Pain expanding to the lower abdomen and groin
  • Pain that comes in waves and varies in intensity
  • Painful urination
  • Pink, red, or brown urine
  • Cloudy or smelly urine
  • Nausea and vomiting
  • Inability to relax after urination
  • Frequent urination in small volumes
  • Fever and chills if there is an infection

What causes the formation of stones? Which ages are more risky?

Kidney stones mostly occur between the ages of 20 and 40. The most common reason for them is the reduction in the urine volume caused by the lack of fluid consumption. Other risk factors include:

  • Ethnicity
  • Gender (kidney stones are more common in men)
  • Previous history of kidney stones (A person who has had a kidney stone once has an increased risk of developing a stone disease in later life)
  • Family history of kidney stones
  • Fluid loss (water loss significantly increases the risk of kidney stones by decreasing urine output)
  • Fatness
  • A diet high in protein, salt or glucose
  • Gastric bypass surgery
  • Inflammatory bowel diseases (may cause increased calcium absorption)
  • Certain diseases (Hyperparathyroidism may cause increased absorption of calcium and phosphorus; renal tubular acidosis may be a risk factor for kidney stones.)

Which methods are used in the treatment of stones? Is it possible to treat stones with medicine?

The treatment of the stone disease depends on many factors such as the location, largeness, and the type of the stone. For the stones that are too large to be dropped naturally, surgical methods or, if the stone is suitable, the method of externally breaking down stones with shock wave therapy (ESWL) is used.

Medicinal treatment is used to facilitate the falling of stones small enough to fall and to solve the patient’s pain and infection problems. It is possible to shrink some rare stones with medication, however, medicational treatments do not make any difference in most of them. On the other hand, there are some treatments to prevent or retard the formation of stones.

While planning treatment for kidney stones, the size and location of the stone in the kidney must be considered.

The two most commonly used methods in the treatment of kidney stones are ESWL (stone breaking with shock waves), and Percutaneous nephrolithotomy (PCNL) (kidney stone surgery with a single hole). In rare situations, open surgery and operations performed by entering through the urinary canal for small stones can be performed.

In stone breaking or ESWL treatment, the stones are broken down with sound waves without any incision on the body. The broken stones go out through the urinary tract. This treatment method is generally preferred for the treatment of stones smaller than two centimeters. During the procedure of breaking down stones, anesthesia is not needed and the situation is kept under control with strong painkillers.

The procedure of breaking down stones by entering through a single hole, shortly PCNL, is generally favored for stones larger than two centimeters. This is a surgical intervention performed under general anesthesia. The stone-breaking procedure is performed by entering into the body through a one-centimeter incision on the skin to reach the stone in the kidney and with the help of cameras that allow seeing the stone. During this procedure, different stone breakers may be used with pneumatic, ultrasonic, or laser energy properties. This operation has now taken the place of open kidney stone surgeries. In some special cases, open surgeries may be used for the treatment of kidney stones.

While planning treatments for the ureteral stones found in the ureters located between the kidneys and the urinary bladder, the size and the location of the stone gains importance. For the treatment of these stone types, ESWL or ureteroscopy, breaking stones by reaching the stone with a thin camera through the urinary tract, may be preferred.

What can we do to prevent kidney stones?

To avoid kidney stones, a combination of lifestyle changes and the use of some medications may be required.

To reduce the risk of kidney stones:

  • Drink water throughout the day. For those who have a history of kidney stones, it is generally advised to drink enough water to produce around 2.5 liters of urine. It may be necessary to measure the urine output to ensure enough water is drunk. Drinking a big glass of water, especially before going to bed, reduces the density of the urine to be produced during the night.
  • Especially those who live in hot and dry climates and those exercising frequently may need to drink more water to produce enough urine.
  • Avoid food that is rich in oxalate. If you have a tendency to develop calcium oxalate stones, which are the most common type of stone, you should avoid foods containing high oxalate. Among others, these foods include beet, okra, spinach, chard, sweet potato, hazelnut, tea, chocolate, and soy products.
  • Limit salt and animal protein. Reduce the amount of salt you eat and prefer non-animal protein sources such as legumes.
  • Continue eating foods rich in calcium, but use calcium supplements carefully. Calcium taken with food has no effect on your risk of kidney stones. Unless your doctor recommends otherwise, continue eating food rich in calcium. As extra calcium supplements may increase the risk of stones, consult your doctor before taking them. You can decrease the risk by taking these supplements together with food. It should also be noted that diets with low calcium content may increase the risk of kidney stones in some people.