The urinary tract is responsible for filtering and eliminating waste from the blood, starting from the kidneys and traveling through the ureter to the bladder and then out through the urethra. When a substance does not properly filter through the urinary tract, it can crystallize into “stones” that can become painful and interfere with the urinary tract function.
If you or someone you care about is suffering from kidney stones or bladder stones, fortunately, there are numerous treatment options available to not only alleviate the pain, but also safely remove the stones. To discuss which treatment option is best suited for you or your loved one, please do not hesitate to schedule a consultation at Comprehensive Urology today! Contact us online or call (310) 499-2756.
What Causes Urinary Stones?
Urinary stones that occur in the kidneys typically occur as a result of excessive calcium, mineral magnesium, uric acid, or cystine in the urine that are not dissolved or washed away, resulting in a build up of the substance, which then crystallizes. Bladder stones often form as a result of urine that remains in the bladder, whether due to failure to completely empty the bladder, inflammation of the urinary tract, or use of a bladder catheter or forgotten urinary stent. The remaining urine and substances in that urine can crystallize if not evacuated quickly enough.
In some cases, certain metabolic disorders can cause recurrent stones, such as:
- Gout – A disorder that results in high uric acid levels.
- Cystinuria – A condition that causes excessive amounts of cystine in the urine.
- Renal disease – Decreased ability to filter wastes out of the blood, resulting in waste buildup.
- Overactive parathyroid glands – A condition that causes excessive calcium in the urine which can lead to recurrent kidney stone formation.
At Comprehensive Urology, our board-certified urologists will conduct careful metabolic evaluation to determine the exact cause of urinary stones, such as metabolic disorders, diet and fluid intake, urinary tract infections, or medications.
Signs and Symptoms of Urinary Stones
It is not uncommon for patients to have kidney or bladder stones without experiencing any symptoms, however, a stone can cause obstruction in the passage of urine in the ureter (tube that brings the urine from the kidney to the bladder) and result in distention or “swelling up” of the kidney by trapped urine which leads to severe pain and discomfort. The symptoms often include:
- Blood in the urine
- Flank or lower abdominal pain
- Urinary frequency and urgency
- Need to urinate frequently
Urinary Stone Types
There are three types of urinary stones: kidney stones, ureteral stones, and bladder stones. There are many similarities between both types of stones, but it is important for patients to receive a proper urinary stone diagnosis to ensure safe, effective treatment.
What Are Kidney Stones?
Kidney stones mostly consist of mineral and salt deposits. They affect the urinary tract and form due to urine crystals that coalesce, resulting in hard deposit formations (stones).
Types of Kidney Stones
Not all kidney stones are identical. The four major types of kidney stones are:
- Calcium stones: Mainly consist of calcium oxalate (about half or more of all kidney stones). Calcium kidney stones are the most common type of kidney stones.
- Uric Acid: Develop when an individual’s urine becomes too acidic. Uric acid kidney stones are more prevalent in men than women, and they frequently affect people who are dealing with gout or undergoing chemotherapy.
- Struvite: Occur due to a kidney infection. Struvite kidney stones are large and cause urinary obstruction and are commonly found in women who are dealing with urinary tract infections (UTIs).
- Cystine: Occur due to cystinuria, a genetic disorder that causes the cysteine acid to leak from the kidneys and into the urine. Cystine kidney stones are rare and found in both men and women.
Causes of Kidney Stones
There are many reasons why kidney stones occur, and these reasons include:
- Dehydration or inadequate fluid intake
- Metabolic disorders or diseases (such as hyperparathyroidism)
- Family history and genetics
- Chronic urinary infection or urinary tract obstruction
- Foreign body inside the urinary tract
- Mineral levels in urine are too high or too low; this often occurs due to certain foods and beverages
Symptoms of Kidney Stones
In many instances, people who are dealing with a kidney stone are unaware of the problem. However, the movement of stones around the kidney (interfering with passage of urine) or trapping of stones inside the ureter may cause individuals to experience various symptoms mainly intermittent excruciating pain and blood being present in the urine.
Individuals who are dealing with kidney stones may experience one or more of the following symptoms:
- Back pain under the ribcage or flank
- Blood in the urine
- Lower abdominal or groin pain
- Urge to urinate or increase in frequency of urination
- Burning with urination or intermittent stream
If a person experiences any of the aforementioned symptoms, he or she should go to a doctor immediately. That way, this individual can receive kidney stone diagnosis and treatment.
What Are Bladder Stones?
Bladder stones form due to a high concentration of certain minerals and substances in the urinary tract. If the bladder fails to empty properly, materials can build up inside the bladder, resulting in bladder stones.
Causes of Bladder Stones
Bladder stones generally consist of crystallized uric acid, calcium oxalate or calcium phosphate, struvite, or other substances. If an individual cannot empty the bladder properly, these materials may build up inside the bladder, leading to the formation of bladder stones.
Additionally, bladder stones have been linked to other causes, such as:
- Enlarged prostate gland not allowing proper bladder emptying
- Frequent bladder infections
- Neurogenic bladder (damaged nerves) resulting in incomplete bladder emptying
- Radiation therapy to bladder
- Kidney stones that pass into the bladder but somehow do not leave the bladder
- Catheter use
- Bladder diverticula (pouches in bladder wall)
Symptoms of Bladder Stones
They may fully silent and without symptoms. Common bladder stone symptoms include:
- Blood in urine
- Painful urination
- Cloudy or dark urine
- Lower abdominal pain
- Frequent urination
- Difficulty controlling urination
If an individual experiences one or more of the aforementioned symptoms, this individual should contact a doctor immediately for proper bladder diagnosis and treatment.
Treatments for Stones in Urinary Tract
Depending on the size of the stone, kidney function, and whether there is an infection, kidney or bladder stones may require no immediate intervention at at all since the stone may safely pass by waiting and controlling patient symptoms also providing medication to help with stone passage. However, if it is necessary to break up, remove, or bypass a urinary stone, the following treatments may be recommended:
- Ureteroscopy – A long, thin, flexible or fiber optic instrument is used to look inside the ureter and kidney to locate and remove the stone(s) with a small basket deployed through the scope or after breaking larger ones with laser energy (Holmium-YAG laser through a small laser fiber which extends from tip of the scope) and then using the basket devices to remove the pieces.
- ESWL (Extracorporeal Shockwave Lithotripsy) – The stones are initially located via X-ray and then treated with shock waves from outside the body using a lithotriptor. The shock waves can successfully break up the stone to dust, allowing them to pass through the urinary tract much more effectively.
- Percutaneous Nephrostolithotomy (PCNL) – Removal of kidney stones through small incisions on the back to create a small tunnel to access the kidneys. This treatment is typically recommended for very large kidney stones or stones that are in a difficult location which cannot be reached by a ureteroscope.
Urinary Stone Prevention
Depending on the cause of kidney or bladder stones, it may be possible to prevent recurrence by adjusting your dietary habits. Following a metabolic work up, our urologists will create a prevention plan and recommend regular metabolic work ups to monitor your progress. The most common steps for preventing urinary stones include:
- Drink at least 2.5 liters or ~ 90 Oz of water a day, increasing the amount during the hotter months
- Reduce sodium intake to no more than 2500 mg a day
- Do NOT limit calcium intake (but do not use excessive amounts wither)
- Cut down on animal protein intake (6-8 Oz / day of all animal protein sources including white or red meat)
- Increase lime and lemon juice intake daily (contain citric acid which is preventive against forming most kidney stones)
- Decrease oxalate intake (if you have calcium oxalate stones): dark green vegetables, nuts, chocolate, strawberry, etc are rich in oxalate and should be used in moderation
Metabolic Evaluation for Urinary Stone Prevention
Kidney stones often develop as a result of dehydration or an imbalance of substances that crystallize in the urine. However, prior to determining the exact cause of urinary stones, the expert team at Comprehensive Urology will first focus on alleviating the symptoms and eliminating the stones with one or a combination of treatments. Once the stones have been passed or removed, we will conduct a metabolic evaluation to create a personalized urinary stone prevention plan.
If you or a family member is suffering from kidney or bladder stones, please do not hesitate to schedule a consultation with Comprehensive Urology in Beverly Hills today. Dr. Akhavein is a fellowship-trained endourologist and expert in all urinary stone disease management and surgeries including the latest minimally invasive approaches for complex stone diseases.
What is Involved in a Metabolic Evaluation?
A metabolic evaluation is a set of diagnostic tests that help determine the cause of stones in your kidneys or bladder. These tests include a urine test, blood work, and analysis of a passed or removed stone, if available. The metabolic work up will provide key information that may be used to prevent stones from recurring.
The most common causes of urinary stones that are identified in a metabolic evaluation include:
- Dehydration – The body is unable to wash out minerals and substances that build up into stones
- Low Citrate – Citrate is a molecule that helps bind calcium in the urine, allowing it to pass through the urinary tract rather than bind and crystallize into stones. Too little citrate in the body can result in stones.
- Excessive Sodium or Protein – Too much salty or fatty foods can cause an increase of sodium or protein in the urine, which can buildup and crystallize, especially if the body is dehydrated.
Contact the Urinary Stone Experts at Comprehensive Urology Today
To find out more about urinary stone treatment options from our expert urologists team including Dr. Arash Akhavein who is a fellowship-trained endourologist who sub-specializes in all the latest urinary stone treatments and minimally invasive surgery. Please contact the kidney and bladder stone experts at Comprehensive Urology today at (310) 596-1409 to schedule a consultation.