Urology
Bean shaped organ, one on each side of the spine, overlying the last few ribs. Main job is to filter impurities and waste from the blood, and regulate body fluid balance. It helps in blood and bone formation too. A stone is formed when certain salts, normally in a dissolved state (like sugar in water).
Kidney Stones
Bean shaped organ, one on each side of the spine, overlying the last few ribs. Main job is to filter impurities and waste from the blood, and regulate body fluid balance. It helps in blood and bone formation too.
A stone is formed when certain salts, normally in a dissolved state (like sugar in water), are above a limit and the excess is thrown out as crystals, which soon combine to form a stone.
As long as the stone is not blocking the flow of urine, you are fine, but since the tube draining each kidney ( the ureter ) is very small (inner diameter 2-3 mm at some points ) once it gets ’jammed’ , it causes urine to dam up in the kidney, leading to severe back pain. The ureter tries valiantly to clear the block by squeezing its muscles, and this leads to severe pain, called ‘colic’.
Any severe pain can make you feel like throwing up, including a severe heart attack. Sometimes the pain killers, which you have to take, make you nauseous.
About 10-15% stones are invisible on X-Ray, especially if composed of cystine or uric acid .
The stone blocks the tube from the kidney. Since there are two kidneys, other kidney continues to function and hence urine reaches the bladder.
Relief of pain is the first objective, assessing the cause, and most effective treatment strategy is the next. An Ultrasound scan, a urine examination , a simple X-Ray to look for stone may be the only tests. 90% of stones are passed by the patients themselves, generally within 2-4 weeks. If necessary, a special CT Scan, will be necessary to assess the problem.
Apart from these social reasons, persistent vomiting/pain/fever make us intervene on an emergency basis. ‘stenting’ a stone, means putting a thin plastic tube from bladder to the kidney, to by-pass the ‘jam’ created by the stone. It is done either from below with a telescope, or sometimes from the kidney side.
Most stones are less than 4-5 mm in size, and will pass spontaneously, treated or not. Credit is given to the last trick/treatment/temple/talisman…. pick your choice ! Seriously speaking, during acute colic, the blocked kidney is temporary shut down ( otherwise it would literally ‘blow up’ a leak ) and hence attempt at ‘flushing’ the stone should be done only after severe pain has subsided.
Not always. Pain disappears once urine can trickle past the stone, but it may come back again if stone wedges tightly again. In some cases, the body ‘gives up’ attempts at pushing the stone out, and hence there is no pain, but gradually the kidney loses its function. Thus, it is important to get confirmation that your kidney is OK if you have no pain, but have not passed the stone either.
Small stones will pass anyway. If you would like to try alternative treatment options, go ahead, most important thing to remember is that you must not assume that treatment is successful because you have no pain. You must get X-Ray or a scan to confirm that you do not have a blocked kidney.
If a stone remains in the body for longer than a month, chances of it coming out without any help is small, and the risk of permanent damage to kidney function also increases if stone remains stuck for more than a month.
Correct treatment for a stone depends upon the size, type, location of the stone and kidney configuration, function etc, apart from other existing illnesses, travel time etc. Most stones are suitable for SWL (Shock Wave Lithotripsy), commonly known as Laser treatment., but not all. Urologist will be able to help you with this issue.
Cystitis
Cystitis means bladder inflammation. Bladder stores urine before we empty it via urethra, the urinary passage. Inflamed bladder (like a cold) is irritable, making you pass urine very frequently and with pain in lower part of the tummy. There is severe burning when you pass urine. You have to rush to pass urine, (urgency). There may be some blood in urine in severe infections, especially at the end.
Commonest cause is bacterial infection. Not uncommon cause is tuberculosis in our country or schistosomiasis in countries like Egypt. Some times stones or other local problems may cause infection. In some young women, sexual intercourse seems to trigger it (Honeymoon cystitis).
As long as the stone is not blocking the flow of urine, you are fine, but since the tube draining each kidney ( the ureter ) is very small (inner diameter 2-3 mm at some points ) once it gets ’jammed’ , it causes urine to dam up in the kidney, leading to severe back pain. The ureter tries valiantly to clear the block by squeezing its muscles, and this leads to severe pain, called ‘colic’.
Generally, first infection, in a woman, is symptomatically treated with a short course of antibiotic. It is necessary to do urine (R+M) Routine examination for sugar, albumin and microscopy for pus cells and Red cells-RBCs- as well as culture sensitivity test (urine C/S) to identify the type of bacteria causing the infection. If infections are frequent and severe, it becomes necessary to try and identify any underlying factors. Apart from Blood Sugar to rule out Diabetes, Ultrasound scan KUB region (Kidney, Ureters , Bladder) is one important test which is painless, and can provide information about ‘left over urine’, stones, dilatation, and other anomalies. Urine culture test for TB (Tuberculosis), specialized X-ray test like MCU (Micturating-Cysto-Urethrogram) and finally, examination of the bladder (cystoscopy) may be required in certain cases to find underlying problems.
Some people are more prone to getting cystitis than others. Certain precautions help :
Plenty of liquids help to ‘wash out’ the bacteria. Water is the best liquid, as long as it is clean and potable. Soft or hard (i.e. Bore-well water) does not matter.
Avoid Constipation. Take green vegetables, salads and fruits (if not diabetic), in plenty.
Regular physical exercise improves circulation and general immunity. Take help of qualified physical instructors if in doubt.
Empty the bladder regularly, once in 3-4 hours is recommended. Especially, getting up in the middle of night, passing urine and drinking a glass of water before going back to bed, is a must if you keep getting lot of infections.
‘Front to back’ action for ablution, after passing motion, rather than using ‘back to front’ action which is more instinctive and easy. The logic is, since most of infections come from our own body and anal region is prime source, the action should be from relatively cleaner area, to dirtier region and not vice versa.
Pass urine immediately after sex. This is to flush out the germs which might attack when there is some lowering of normal defence.
Do not use Tampoons. Pads are preferable if one is prone to infections
No douche/ ‘cleaning’ the vagina using antiseptics/lotions like V wash etc. to be used. Natural fluid secretions of vagina has inherent antibacterial action.
Yes, provided approved earlier by the urologist. Even then, before taking antibiotic, collect a Clean Catch Mid Stream Urine sample for R+M and C/S tests -in a sterile container (obtained earlier from The lab with cellophane wrapper intact) and submit to the lab, if lab is open or store in the fridge(Not Freezer)in a plastic bag overnight and submit next working morning. Insist on test being done on that overnight specimen, collected before antibiotic and stored at 4˚C, rather than giving a ‘fresh’ sample, which will be post antibiotic, and hence of not much use.