Kidney Stones

Urinary system stone disease has been affecting people since ancient times. Archaeological studies have revealed that a bladder stone was found in a male skeleton dating from 4800 BC, the oldest in Egypt. Today, the lifetime chance of getting stone disease varies between 1-15%. Our country is an endemic region for stone disease. The incidence of stone disease is higher, especially in the South and Southeast regions. This is thought to be due to the high loss of fluid due to the hot climate. Stone disease is more common in men than women. Familial and environmental factors are involved in the development of stone disease. The risk of stone formation is higher in people with high body weight and low fluid consumption. In addition, stone disease can accompany systemic diseases such as hyperparathyroidism and gout. People with anatomical disorders in the kidney and urinary tract are more prone to stone disease. Many chemical mechanisms have been described for stone formation. Calcium oxalate, calcium phosphate, cystine, uric acid and infection (magnesium-ammonium-phosphate) stones are seen most frequently.

The most common symptom in stone disease is flank pain. The pain is often very severe and sharp and is called renal colic. Sometimes blunt pain can also be seen. The pain can hit the groin area, the testicles in men, and the vaginal area in women. Complaints such as bleeding in the urine, burning, frequent urination, fever, nausea and vomiting may also accompany. Sometimes stones can remain silent for a long time without any symptoms. In diagnosis, history, physical examination, urine and blood tests, as well as imaging methods such as direct x-ray, ultrasonography and non-contrast computed tomography are used. Analysis of stone samples obtained after the treatment of stone disease is important to determine the type of stone. Further metabolic evaluations should be performed in patients with stone type cystine, uric acid or infection stones, family history, frequent recurrences and pediatric patients.

The treatment in stone disease varies according to the location of the stone, its size, the type of stone, pain and obstruction in the urinary tract. In the treatment of kidney stones; Small stones that do not harm the kidney can be followed without treatment. Stones smaller than 2 cm can usually be treated with Extracorporeal Shock Wave Stone Crushing (ESWL) or Retrograde intrarenal surgery (RIRC). It may be necessary to apply these processes together or in several sessions. Percutaneous nephrolithotomy (PNL) surgery gives more successful results for stones larger than 2 cm. In the treatment of ureteral stones; ESWL and rigid/flexible ureteroscopy methods are successfully applied treatment methods. For the treatment of obstructions, DJ stent or nephrostomy catheters can be applied for temporary periods.

Stone disease is a recurrent disease. For this reason, regular follow-up should be done by a urologist. Increasing fluid intake, proper diet and exercise play an important role in preventing recurrences. The daily fluid should be taken by spreading over the hours. It is recommended to drink a glass of water per hour while the person is awake. This equates to about 2-3 liters per day. It is known that lemon and orange juice can prevent stone formation. In diet; Although the diet differs according to the type of stone, it is recommended not to consume too much milk and dairy products, green vegetables and fruits, foods containing cocoa, acidic beverages, alcohol, tea, cookies and salt.

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