One day, Mr. Go felt a vague discomfort and pain in his stomach. It was as if he needed to go to the men’s room but when he tried (and he tried for three or four times) there were no “results.” It was getting to the point where he felt that he wanted to throw up, but couldn’t and the pain was still there, with no improvement whatsoever. The pain would wax and wane and when severe it would radiate to his lower abdomen.
It was at that time that I met Mr. Go in my clinic, and did a thorough examination. It was quite strange that he did not have tenderness at any point in the abdomen, and also the X-ray revealed no abnormal findings, except for some gas in his intestines.
It definitely wasn’t something with the stomach, or the bowel... and so I referred him to a bigger hospital. Mr. Go was referred to a GI specialist, and then to a urologist. He went through a pyelogram (a specialized radiological examination tool using a dye to outline the urinary tract) and was diagnosed as having a bladder stone.
Urinary tract stones, in this case a kidney stone, is literally a stone that is formed in the kidney (nephrolithiasis). A stone in the ureter, or the kidney is called ureterolithiasis (ureteral stone), or a cystolithiasis (bladder stone).
There are many reasons for the formation of stones in the urinary tract, from over-saturation of urine, leading to kidney stones; excessive calcium in the urine, that easily leads to the formation of the core for a stone; inflammation in the bladder, or an indwelling catheter in patients with difficulty voiding leads to stones in the bladder, to name a few.
Symptoms of stones in the urinary tract may differ in consideration to where the stone is, and if the stone is blocking the passage or not. Also, the existence of damage to the tract due to the stone may have symptoms.
The key symptom is colicky pain. Pain that’s on and off, irregularly. Depending on the situation/position of the stone, the symptoms may vary to a certain extent, but it’s mostly a pain that’s colicky and situated on the lower back, anterior thigh, sometimes extending to the genitals. The symptoms also may be so obvious like blood tinged urine (hematuria) or vague, like back pain and indigestion.
A small stone in the tract may just pass through and you might be able to urinate the stone. But in many cases, the stone is too big, and unable to pass, and that can lead to pain while urinating, blood in the urine, difficulty in urinating, and sometimes darker colored urine. If the stone is too big as to induce a total blockage, serious complications, such as damage to the organs above the stone (bladder, kidney damage) or concomitant infection may occur.
The treatment can be quite easy, happen randomly, or may take quite some time to treat. Plenty of water ingestion for urination, may just let the stone (that is not too big obviously) pass through with the urine. Not many people with this condition come off this easily. The aim is to break the stone into little pieces and let them then pass through the urinary tract. It can be done using a cystoscope, a camera that goes directly inside, and break the stone. Another choice would be a device abbreviated as ESWL (Extracorporeal Shock Wave Lithotripsy). A probe generating a shock wave that is passed on to the stone and breaks it.
As for Mr. Go, he is happy that he’s having less pain and less “digestive” problems, but feels quite unpleasant about having to go to a urologist every week, having to save up some money for the ESWL treatment, and having to urinate “little stones” in the toilet every time he goes to pee.
Doctor Joon Moon. M.D. (Doctor Jay) graduated from Korea University Medical School, and trained at Korea University Medical Center (KUMC). He is currently the chief executive of Everspring Rehabilitation Hospital in Jeju. If you have any questions concerning health matters, ask Dr. Moon at firstname.lastname@example.org
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