Introduction: What are urinary stones?


Urolithiasis is a disease characterized by the formation of one or more aggregates (calculi) of different chemical composition, texture and size in the urinary tract. The calculi may be located in the cavity of the renal excretory level, ureter or bladder.



Symptoms: How can I know I am suffering from urinary stones?


In most cases, urolithiasis is entirely asymptomatic, appearing as an occasional discovery at control examinations (e.g. Abdominal ultrasound) performed for other reasons. In other cases, the calculi can instead present with typical acute symptoms: renal colic.


It is characterized by a very intense and sudden pain, which may occur at different times of the day. The pain is caused by the obstacle to the passage of urine, due to the arrest at the level of the ureter (the tube that connects the kidney to the bladder). This obstacle causes a pressure increase upstream of the calculi, resulting in the expansion of the renal excretory cavity. It is a pain that can last from several minutes to several hours, occurs in the lumbar region and often radiates along the course of the ureter, into the bladder and the external genitals. It can be accompanied by symptoms such as nausea, vomiting, tachycardia and fever, especially in cases where renal colic is associated with a urinary tract infection. Sometimes the pain can also be accompanied by hematuria, either microscopic (presence of detectable blood in an examination of urine) or more rarely macroscopic (blood in the urine visible to the naked eye).


Epidemiology: How common are urinary stones?


Urinary stones is a very common disease in the Western population: recent studies have shown that about 10% of the population develops at least one episode of urinary stones during their lifetime, with greater involvement of men than women (ratio 2:1). In Italy about 250,000 people are affected by an episode of urinary stones every year, either primitive or a relapse. It most frequently occurs between the ages of 30 and 50, but any age group can be affected.


Diagnosis: how to diagnose urinary stones?


The diagnosis of urolithiasis initially requires a series of laboratory tests and instrumental examinations such as: urinary tract ultrasound and X-Ray vacuum of the abdomen. The ultrasound examination allows direct visualization of the urinary stones and, in case of a possible expansion of the urinary tract, it also shows any ureteral stones. The X-Ray of the abdomen instead displays radio-opaque images along the presumed course of the urinary tract. In anticipation of surgery for kidney stones, second level instrumental tests may be necessary, including CT of the abdomen, urography or ascending pyelography.


Treatment: How can urinary stones be cured?