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Ureteric Stones

The stones which are stuck within one of the two ureters, the tube leading from the kidney to the bladder are called Ureteral stones. If the stone is large enough, it can block your flow of urine from the kidneys to the bladder. A ureteric stone is essentially a kidney stone. Just that, in this case the kidney stone moves from the kidney into the other part of the urinary tract. These stones are common. 

Symptoms – 

The most common symptom of a kidney or a ureteric stone is severe pain. 
You might feel pain in your lower abdomen or your flank, which is the area of the back just under your ribs. 

Other possible symptoms may include:

  • Pain or burning sensation while urinating
  • Nausea 
  • Vomiting
  • Blood in your urine 
  • Frequent urge to urinate
  • Fever 

Consult your doctor right away if these symptoms occur. 
What causes these stones?
Ureteric stones are created by crystals in your urine which combines. They are usually formed in kidneys before passing into the ureter. 

These stones can be formed by different kinds of crystals and most commonly composed of Calcium Oxalate. 

There are certain factors which can raise your risk of having these stones, which include:

  • Family history 
  • Dehydration
  • Diet
  • Certain medications 

There are few medical conditions which can lead to ureteric stones:

  • A blockage in the urinary tract
  • Gout
  • Hyperparathyroidism 
  • Obesity 
  • Recurrent UTIs

Diagnosis –

Your health care provider may suggest diagnostic imaging tests to look for stones. There are two most common imaging tests for stones, which includes:

  • A computed tomography (CT) scan: This is usually the best option for detecting stones in the urinary tract. 
  • An ultrasound- Unlike a CT scan, does not use radiations. This procedure uses high-frequency sound waves to produce the image of the body.

These imaging tests can help your Urologist to determine the exact location of the stone, as well as the size of the stone and which treatment plan is best for you. 

Treatment

Small stones tend to pass more easily. 
Larger or a wider stone is hard to pass by its own and Urologist may suggest some of the following procedures for you:

  • Medical expulsive therapy – This type of therapy involves the use of alpha- blocker drugs to help the stone to pass. 
  • Shock wave lithotripsy – This procedure uses shock waves to break the stones into smaller pieces, and then can be easily passed in the urine. 
  • Ureteroscopy – A thin tube with a scope will be inserted into your urethra and up into your ureter. The stones can be removed directly or broken down in small pieces by the help of laser to pass it by its own. 

In case of Fever or presence of Infection along with obstruction in passage of urine due to completely obstructing stone, you need some form of intervention procedure to bypass the obstruction along with antibiotics for few days. The intervention procedure can be either 

  • Ureteral stent placement – A small tube is passed into the ureter around the stone, allowing urine to bypass the stone. 
  • Nephrostomy tube placement – A Urologist can temporarily relieve the pain by placing the tube directly into the kidney through the back using only sedation/local anesthesia and a combination of x-rays and ultrasounds. 

Once infection settles in few days, will require removal of stones either by Shock wave Lithotripsy or by Ureteroscopy

Prevention

  • Drink plenty of fluids
  • Watch your salt and protein intake
  • Limit high-oxalate food
  • Balance your calcium intake 
  • Review your current medications