Often, the medical history already gives the doctor the first clues; during the physical examination, it can sometimes trigger a knocking pain over the flanks. Examination of urine and blood reveals signs of inflammation and provides information about kidney function. Clarity can also be obtained about possible causes. If it is possible to collect small stones spontaneously passing with the urine using a sieve, their composition can be examined in the laboratory. This provides valuable information about possible causes and useful therapies.
Detecting kidney stones
Ultrasound examination can be used primarily to detect stones in the kidney, and computed tomography can be used to assess the surrounding structures.
A simple X-ray examination shows only certain types of stones, so a contrast medium is usually also injected (urogram), which can also be used to visualize the renal pelvis, ureters and urinary bladder, and stones show up as cavities.
More precise results are obtained by injecting contrast medium directly into the ureter during a cystoscopy. Sometimes stones can be removed directly during this examination. In cases of doubt, the physician may extend the endoscopy to the kidney, although this is not without risk of complications.
Treatment of kidney stones and urinary stones.
Even if kidney stones do not cause symptoms, they can lead to complications such as kidney inflammation or kidney failure. Therefore, efforts are made to prevent further formation. Helpful steps here include:
- High fluid intake
- Physical exercise
- A diet tailored to the specific stones and causes
- Medication
If symptoms have already occurred, the treatment of kidney stones depends on the current situation. An acute renal colic is treated with antispasmodic and analgesic drugs, an infection with antibiotics. In two-thirds of those affected, the kidney stones (urinary stones) go away spontaneously. For larger stones or complications, there are several options for kidney stone removal.
Removing kidney stones
Kidney stones can be removed in several ways:
- Drug therapy: uric acid stones such as those that occur in gout can be dissolved by medication to deacidify the urine. At the same time, uric acid-lowering tablets are given and the affected person must change his diet to a low-purine diet.
- ESWL (Extracorporeal Shock Wave Lithotripsy): stones in the kidney or at the beginning of the ureter can be broken up by shock waves from the outside. The smaller pieces thus produced can then pass with the urine.
- Reflection of the ureter and kidney (ureterorenoscopy) and removal of the stone with grasping forceps or a basket, respectively, the crushing of the stone by laser or ultrasound.
- Direct puncture of the kidney through the skin under ultrasound and X-ray guidance and crushing of the stone on site.
- Open surgery: only very rarely required; usually simultaneous correction of anatomical malformations such as narrowing of the ureter.
Avoid kidney stones through diet
The risk of developing kidney stones repeatedly is relatively high. The risk of developing kidney stones can be significantly prevented with preventive measures. These include:
- A daily fluid intake of two to three liters.
- A diet low in protein and salt, high in fiber, with plenty of fruits and vegetables (which inhibits stone formation)
- Achieving and maintaining a normal weight (without radical diets).
- Sufficient exercise
Whether someone has drunk enough can be easily determined by the color of urine: If it is thin and very light, almost like water, the amount of drinking is sufficient – this urine can practically not form kidney stones. Therefore, it is important to drink regularly. It is best to put one or two bottles of mineral water in a clearly visible place, for example on your desk. In this way, you will not forget to take in fluids even in the stress of everyday life and can prevent kidney stones.
