SYMPTOMS AND SIGNS ,DIAGNOSIS AND PROGNOSIS OF KIDNEY STONES
These vary with the size, shape and position of the stone. Minute, smooth stones or gravel diameter less than 5 mm may be passed without symptoms. A smooth stone fixed in one of the calices of kidney, and without infection, may remain for years without symptoms and signs.
The most common symptom of a larger stone is intermittent dull pain in the flank or back, intensified by motion or a sudden jolt, sometimes dysuria [painful urination]. Abnormalities in the urine occur one time or another in 80 % of cases; albuminuria [protein in urine], which may be minimal, while hematuria [red blood cells and white blood cells in the urine] and pyuria [pus in the urine] each occurs in about half of cases.
A rare happened is the classic attack of renal colic caused by the passage of the kidney stone into and down the ureter, the stone large enough to obstruct it in the ureteral-bladder junction. There is a sudden onset of severe pain on the affected side; abdomen, radiating to the groin, bladder, testes, inner thigh or other adjacent areas. The pain is frequently sufficient severe to induce nausea, vomiting, profuse sweating, faintness and shock .If there is infection, there will be fever and leukocytosis [increase white blood cells in the blood] in addition. The attack may last only a few minutes, but usually persists for several hours. A patient may have but one attack of colic and pass the stone without further difficulty, or with multiple stones there may be repeated attack over a period of years.
EXAMINATION AND DIAGNOSIS
In patients suffering from typical attacks of renal colic, the diagnosis can be made with comparative case from the clinical history and is supported by laboratory examination.
Laboratory examinations of urine with the presence of blood [red blood cells and white blood cells] and numerous crystals in a freshly voided urine. A catheter specimen should be obtained in women.
Under microscope the calcium oxalate is found in the acid urine sediment at two distinct types of crystals: the dumbbell and “octahedral” types. Calcium
Phosphate [Stellar Phosphate] may occur in the neutral urine in 3 forms: amorphous, granular or crystals; the crystals as individual or group together in the formed rosettes. Uric acid sediment of urine which is acid in reaction; it occurs in varieties of crystals being rhombic prism, prismatic rosettes or hexagonal plates. Cystine crystallizes in the form of thin, colorless, hexagonal plates.
Nevertheless, the diagnosis can be established only by x-ray, ultrasound or pyelogram study.
At times the shape and type of the shadows seen on x-ray plate are characteristic: Calcium oxalate stones may have a snowflake form with spicule [a slender pointed body] radiating from a central hard focus. Lamellar stones are usually phosphate in composition. Large stag-horn stones are calcium phosphate, calcium carbonate or cystine. Uric acid, urate and cystine stones often fail to give a visible shadow. Intravenous pyelogram [contrast medium graph of kidney] may outline the stone. The doctor may decide to scan the urinary system using a computerized tomography [CT] scan. The result of this test help determine the proper treatment.
PROGNOSIS [ A forecast of the course of kidney stone]
The prognosis in patients with kidney stone is extremely variable, depending upon the size, shape and position of the stone, and the presence of obstruction and of infection. Small stones retained may do no harm, the stones less than one cm diameter, width or length are likely to pass spontaneously, while stones more than one cm diameter, width or length are unlikely to pass spontaneously. Irregularly shaped stones are unlikely to pass spontaneously. All stones tend to grow if no treatment of the kidney stones.
Kidney stone without treatment is one of the most common causes of infection and hydronephrosis [obstruction of urine in the kidney], which may give rise to renal insufficiency, uremia and generalized sepsis.
What are the treatment options of kidney stones?
THE TREATMENT OPTIONS OF KIDNEY STONES ARE:
Simple and low cost treatment of kidney stones, the writer experiences.
Conservative forms of medical treatment
Surgical treatment
The next subtopic:
SIMPLE AND LOW COST TREATMENT OF KIDNEY STONES
No comments:
Post a Comment