What is Urolithiasis: Causes, Symptoms, Treatment, Diagnosis

Urolithiasis is a pathological condition of the Genitourinary System which is referred to as formation of calculi or stones within the urinary tract. This includes the formation of stones in the kidneys and the ureters obstructing the flow of urine and causing pain and other symptoms. In some cases, Urolithiasis may also be formed in the bladder or urethra.

There are many causes including lifestyle habits or certain dietary elements or medications which tend to increase the risk of an individual developing Urolithiasis. Although Urolithiasis is quite a common condition, it tends to cause intense pain and in some cases blood in the urine.

Studies suggest that about 5-10% of the population in the United States tend to develop Urolithiasis at some point in their life even though in some cases this condition may go unrecognized as they tend to be asymptomatic. Around 1% of the population is estimated to be admitted to the hospital for treatment of Urolithiasis.

This condition tends to be found more in males than females as males tend to excrete more calcium than females and hence the increased risk for calcification of the urinary tract resulting in stones. People between the ages of 20-40 are most at risk for developing Urolithiasis.

Any obstruction of the flow of urine may result in an increased risk for Urolithiasis. Some of the risk factors for Urolithiasis are:

Sex: As stated above, males tend to excrete more calcium than females and hence are at an increased risk for developing Urolithiasis.

Ethnicity: Native Americans and Africans are more at risk for developing Urolithiasis than individuals of other ethnic backgrounds.

Family History: Urolithiasis in some cases tend to run in families and if there is a family history of this condition then that individual is at an increased risk for developing Urolithiasis, especially in families that have a history of producing more mucoprotein in the urinary system, which facilitates stone formation

Medical Conditions: There are certain medical conditions that tend to increase the risk for developing Urolithiasis of which the more prominent is GI system conditions and recurrent urinary tract infections.

Diet: Diet plays a key role in increasing the risk for development of Urolithiasis. An individual with reduced fluid intake is at a greater risk for developing Urolithiasis than others. Additionally, increased consumption of sodium, fat, protein, sugar, and excessive vitamin C also increases the risk for Urolithiasis.

Medications: There are certain classes of medications like ephedrine, thiazide, and allopurinol that increase the risk for development of Urolithiasis.

Some of the symptoms of Urolithiasis are:

• Kidney or ureteral colic
• Hematuria
• Frequent urinary tract infections
• Pain in and around the abdominal area
• Severe pain in the flanks
• Increased urgency and frequency of urine

In order to diagnose Urolithiasis, the concerned physician will first take a detailed history as to when the symptoms started and the severity of the symptoms. This will be followed by a brief physical examination where the physician will palpate the abdominal area and other areas of pain to look for any areas of tenderness that may point towards Urolithiasis being the culprit behind the symptoms. Apart from this, there may be certain studies conducted to confirm the diagnosis of Urolithiasis and include:

• Urinalysis so look for signs of blood, pus, or other signs of infection
• Complete blood count to look for signs of infection
• Intravenous Pyelography is done once a stone is identified to look at the location and the size of the stone
• Advanced radiographs like CT and MRI scans may be done to visualize the entire urinary tract and look for any signs of stones
• A Renal ultrasound may also be performed to look for signs of stones and detect obstruction in the urinary system

The results of the above tests virtually confirm the diagnosis of Urolithiasis.

The treatment of Urolithiasis is basically conservative as majority of the stones once identified can be excreted through the urine if they are small. For this, the patient will be advised to increase salt and water intake to increase production of urine so that the stones can pass. For the pain, the patient may be given mild pain killers for pain relief.

In cases of acute pain due to Urolithiasis, the patient may be given NSAIDs for pain relief. If the size of the stones is quite large and is not able to be passed through urine, then laser therapy is done to break the stones into tiny fragments which can then be flushed out easily through urine. In some cases, surgery may be required to remove the stones and treat Urolithiasis.