What is Urinary Stone Disease?
Urinary stones are solid masses of minerals that have formed and crystallised in the kidneys or sometimes the bladder. The function of the kidney is to excrete waste products and fluid from the body to form urine. However, when the body has too much waste and not enough fluid, the waste products can sometimes stick together and build up, forming a mass of solid waste called a stone. These stones will increase in size unless they are passed out of the body through the urine.
How can I treat Urinary Stone Disease?
The treatment of a kidney stone largely depends on the size of the stone, the mineral composition of the stone, the pain experienced by the patient, and whether the stone is interfering with or blocking the urinary tract. In order to make the correct decision for treatment, your doctor may issue scans, urine tests, blood tests or analyse the past sample of passed stones.
If the kidney stone is small, then your doctor may instruct you to increase your intake of fluids to flush out the stones. Your doctor may also prescribe some oral medication to relieve the pain or to reduce the uric acid present in the urine and maintain the alkalinity of your urine.
If the kidney stone is large, a variety of surgery treatment methods may be used to remove the stone. The location of the kidney stones may also play a role in the decision behind the method of surgery used. This can be summarised in the table below.
| Surgery | Description |
| Extracorporeal shock wave lithotripsy (ESWL) [1] | Done under general anaesthesia and usually takes 45min-1h A non-invasive technique Involves using shock waves to break up the kidney stones into small pieces. After the treatment, the stones will be broken down into smaller pieces and be able to exit the urinary tract in the urine. |
| Ureteroscopy (URS) | Done under general anaesthesia, a day surgeryA long tube-shaped tool will be used to locate and remove the kidney stones. Laser lithotripsy — used to break down the bigger stones into smaller pieces to enable them to pass through the urinary tract and exit as urine. |
| Percutaneous nephrolithotomy (PCNL) | Done under general anaesthesia, will require hospitalisation A tube will be inserted directly into the kidney to locate and remove the stone. |
| Retrograde intrarenal surgery (RIRS) | Done under general anaesthesia, either as a day surgery or with overnight stayA flexible ureteroscope is placed through the urethra and move up the urinary tract system to the kidney. The stone is examined through the scope and laser fibres / small forceps or baskets can be used to fragment the stone. |
How can I Prevent Urinary Stone Disease?
While there is no definitive way for one to prevent the development of future urinary stones, there are several measures that can be taken to reduce your risk of developing kidney stones.
Dietary Changes
| Change | Description |
| Have sufficient daily fluid intake | Drinking sufficient liquids (around 3 litres daily) will lower your risk of forming new stones as the solid wastes will be flushed out of your system. After exercising or in hot weather, it is especially important to replace fluids lost by increasing fluid intake. Do talk to your doctor about your recommended fluid intake. |
| Reduce salt and protein in the diet | This is especially for people with high sodium intake, and high calcium/cystine contents in the urine. Some foods are high in salt content, and therefore should be consumed in moderation. These include Cheese Most frozen foods and meat Canned vegetables and soups Bread, bagels, rolls and other baked goods Bottled salad dressings, certain breakfast cereals Olives and pickles Canned and bottled sauces Certain condiments Eating less meat may help if you develop cystine / calcium oxalate stones. This may mean decreasing the frequency or portion size of meat consumption. |
| Regulate and consume the recommended amount of calcium | Some patients consume too much calcium, while others consume too little and require calcium supplements. Hence, it is important to discuss with your doctor the recommended level of calcium you should be consuming. Good sources of calcium are frequently those low in sodium content. Consuming calcium-rich foods/beverages daily is typically a good habit, but it is important to check with your dietician or doctor. |
| Increase intake of fruits and vegetables | Fruits and vegetables contain many nutrients and oxidants that may help prevent stones from forming. The recommended amount is to consume at least five servings of fruits and vegetables daily for people who are at higher risk of developing kidney stones. |
Kidney stones can vary widely in size, composition and pain levels, so it’s important to consult with a doctor to determine the best course of treatment. Your doctor may order scans, urine tests or blood tests to make a diagnosis, or they may analyze a sample of passed kidney stones. In most cases, small kidney stones will pass without treatment, but larger ones may require medication or surgery.
If you or someone you know is concerned about kidney stones, please share this information.
