HisandHerHealth: Information About Sexuality, Prostate, Incontinence

Stones in all parts of the urinary tract, kidney, ureter, bladder and urethra,have plagued mankind forever. The first recorded evidence of urinary tract stones is in Egyptian mummies dated to 4800 B.C. The first recorded operation for stones was in the 12th century B.C. Stones can occur anywhere in the urinary tract including the kidneys, ureters ( the tube from the kidneys to the bladder), bladder, prostate, and urethra ( the tube from the bladder to the tip of the penis or the opening in the vagina). They have been a major source of pain, infection, kidney damage, and death throughout history. Until the 1980's urinary stones were a major cause of urologic surgery. Much research has been done on the incidence, causes, and treatment of stones over the years. This article will review these topics with special emphasis on one of the major technological advances in the history of medicine: shock-wave lithotripsy.

Although it is known that hereditary factors are important in certain types of urinary tract stones, it appears that dietary and environmental factors may be equally as critical, as it is not unusual for spouses of stone formers to have to form stones as well. Stones are more common in males by a factor of three, and are more common from 20 to 40 years of age. The United States has a relatively high incidence of kidney stones for its population, with the Mid-Atlantic and Southeast being the so-called stone belt. Temperature and humidity also seem to play a role. While there is universal agreement that high fluid intake is important in prevention of stones, there is more controversy regarding diet although it would seem logical that dietary factors would contribute to stone formation.

A significant number of people with these stones have increased calcium or oxalate in the urine. Increased urinary calcium can result from an abnormal increased absorption from the intestine due to hereditary factors or bowel disease; excess leakage of calcium from the kidneys, may be due to immobilization after surgery or an injury,or from certain medical conditions. Excessive urinary oxalate my be the result of bowel disease or dietary imbalances.Your urologist will probably test for these. Dairy products are a primary source of calcium, leafy, dark green vegetables, (spinach, collard greens, etc,), and colas are primary sources of oxalate.

Uric acid stones are common in people with gout and in people who excrete large amounts of uric acid in the urine. Uric acid stones can not be seen on x-ray, and require special tests, such as an IVP, (x-rays with injected contrast), spiral CT scans or sonography to be found. Uric acid stones can be due to family factors, various medical conditions or diets very high in animal proteins. This is the only stone that can be reliably dissolved with medical treatment.

Struvite or infection stones are typically associated with chronic urinary infection and should be looked for in patients with urinary tract infection that is difficult to clear. Struvite stones are usually visible on x-ray studies. Unfortunately, in the early stages only bladder symptoms may occur and the stones may progress silently, growing to fill the kidney, (staghorn calculus), and possibly destroy it.

Miscellaneous stones such as cysteine or xanthine are rare. They may be hereditary in origin or related to certain medical conditions or medications. They are variable in visibility on x-ray, and require specialized treatment to treat.