Ureteral stones are mostly stones that have formed in the kidney and migrated down and got stuck in the ureter. Ureters are the tubes that connect the kidneys to the bladder. When stuck in the ureter these stones block the urine drainage of the respective kidney and in response the body tries to squeeze them out in order to get rid of them leading to various symptoms, such as pain, nausea, vomiting, blood in urine, difficulty in passing urine or increased frequency of urine. The pain is felt radiating from the back to front, lower abdomen and at times to the testes in males or the labia in females. Most of the small stones i.e. 5 mm or less can pass out spontaneously with the help of medicines. If bigger and troublesome they are removed endoscopically.
What are Ureteral Stones?
Ureteral stones are irregularly shaped solid masses or crystals that become lodged in the ureters. The ureters are muscular tubes responsible for carrying urine from the kidneys to the bladder, with each kidney having one ureter.
Ureteral stones can develop in either the left or right ureter. In most adults, the length of the ureters ranges from 10 to 12 inches. The stones may occur near the proximal end (close to the point of origin) or the distal end (away from the point of origin) of the ureter. The proximal end connects to the renal pelvis, a central structure in each kidney that collects urine, while the distal end connects to the bladder.
Ureteral stones are typically small, with some being too tiny to see with the naked eye. These small stones pass through the urine without causing any issues. However, larger stones can obstruct the urine flow from the kidneys to the bladder, leading to severe pain. Ureteral stones form due to the buildup of minerals and salts in the urine, which then crystallize and grow into stones.
Are ureteral stones the same as kidney stones?
Yes, ureteral stones are a type of kidney stone that has become lodged in the ureters.
Who is at risk of developing ureteral stones?
Ureteral stones can affect anyone, but certain factors increase the risk. You have a higher chance of developing ureteral stones if you:
- are a male
- are between the ages of 20 to 50
- have a history of ureteral or kidney stones.
- have a family history of ureteral stones.
- have low water intake.
How common are ureteral stones?
Over a lifetime, the likelihood of developing a stone is 1 in 8.
SYMPTOMS AND CAUSES
What are the symptoms of ureteral stones?
Tiny ureteral stones may pass through the urinary system without causing noticeable symptoms. However, stones that obstruct the ureters or kidney’s drainage tubes can lead to the following symptoms:
- Intermittent severe pain in the upper flank region (back, below the lower ribs).
- Radiating pain spreading to the lower abdomen.
- Pain or a burning sensation during urination.
- Nausea.
- Vomiting.
- Bloody or discolored urine (brown, pink, or red).
- Cloudy urine.
- Frequent urge to urinate.
- Urinating only a small amount.
What causes ureteral stones?
Ureteral stones form when there is an excess of stone-forming substances in the urine. Under normal circumstances, these substances pass through the urinary system without complications. However, when there is insufficient urine volume to dissolve or flush out these substances, they can crystallize and form stones. Inadequate water intake is a common cause of reduced urine volume.
What substances make up ureteral stones?
Ureteral stones can consist of the following substances:
- Calcium
- Oxalate
- Uric acid
- Phosphate
- Cystine
- Xanthine
How long can a stone stay in the ureter?
The time it takes to pass a ureteral stone can vary from person to person. Additionally, some individuals may be unable to pass or expel the stone naturally.
In many cases, stones smaller than 4 millimeters may pass within one to two weeks. Once a ureteral stone reaches the bladder, it typically passes within a few days.
It is not always that a stone lodged in the ureter passes away in the urine. If a stone gets stuck and impacted in the ureter it gradually increases in size and decreases the drainage from the kidney leading to back pressure over the kidney. Gradually the obstructed kidney starts to lose its function and at times become completely nonfunctional just because of a small stone. So its very important to make sure that the stone has either passed away spontaneously or is removed out endoscopically.
DIAGNOSIS AND TESTS
How are ureteral stones diagnosed?
A healthcare provider will inquire about your symptoms and perform a physical examination. They may also order tests to confirm the presence of ureteral stones.
What tests are used to diagnose ureteral stones?
Tests commonly used to diagnose ureteral stones include:
- Urinalysis: Checks for signs of infection and examines substance levels in your urine that contribute to the formation of ureteral stones.
- Blood test: Assesses kidney function, detects infection, and identifies other potential causes of ureteral stones.
- Ultrasound: Uses sound waves to detect blockages in the ureters.
- Computed tomography (CT) scan: Provides information about the size, location, and hardness of ureteral stones.
MANAGEMENT AND TREATMENT
How can ureteral stones be treated?
The treatment of ureteral stones depends on their size, location, and composition. The feasibility of passing the stone naturally is also considered.
For larger stones or urinary tract blockages, a urologist may recommend the following treatment options:
- Medical expulsive therapy (MET): Effective for treating small distal ureteral stones. MET involves the use of medicines to relax the ureter and decrease swelling at the site of obstruction of the ureter so that the stone can pass out on its own.
- Ureteroscopy: Involves inserting a thin tube equipped with a camera (ureteroscope) through the urethra, bladder, and into the ureter. The urologist can then remove or break up the stone using laser technology.
- RIRS: For stones lodged in the upper ureter
- Shock wave lithotripsy: Uses high-energy shock waves to break up the stones, enabling smaller pieces to pass more easily through the urinary tract. This procedure is minimally invasive but may not be suitable for everyone.
- Percutaneous nephrolithotomy: In this procedure, a urologist inserts a scope directly into the kidney through a small incision in the back to locate and remove the stones. This approach is typically recommended for larger or irregularly shaped stones.
- Ureteral stents: Temporary, thin, and flexible tubes placed in the ureters to keep them open and allow urine to flow around the obstructing stone.
How can I manage symptoms and take care of myself?
To alleviate symptoms and promote stone passage, it is recommended to drink plenty of fluids, aiming for at least 2-3 liters per day. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, or naproxen can provide relief from mild pain or discomfort. However, it is important to consult your healthcare provider before taking NSAIDs, as they may not be suitable for everyone.
Recovery time from treatment can vary, but most individuals start feeling better within a few days. However, side effects may persist until all remnants of the ureteral stones have passed.
PREVENTION
How can ureteral stones be prevented?
Several measures can be taken to prevent the formation of ureteral stones:
– Increase fluid intake: Aim to drink at least 2–3 liters of fluids daily, preferably water. Lemonade or orange juice can also be good options.
– Limit animal protein: Reduce the consumption of meat, eggs, and fish, as they increase uric acid levels. Lentils, beans, green peas, seitan, and tofu are alternative protein sources that do not raise uric acid levels.
– Restrict sodium (salt) intake: Consuming less than 1,500 milligrams of salt per day can lower the risk of developing ureteral stones. Salt substitutes, herbs, spices, lemon juice, or flavored vinegars can be used as alternatives.
– Control oxalate intake: Oxalate-rich foods such as spinach, almonds, cashews, and potatoes should be limited. Calcium-rich foods and beverages can help prevent the crystallization of oxalate.
– Collect stone for analysis: In some cases, healthcare providers may request that you to urinate through a strainer or filter until the stone passes. The collected stone can then be analyzed to determine its composition and guide the prevention strategy.
OUTLOOK / PROGNOSIS
What can be expected when dealing with ureteral stones?
With proper diagnosis and treatment, the outlook for individuals with ureteral stones is generally good. However, there is a possibility of recurrent stones.
Many people pass small ureteral stones naturally without requiring treatment. For larger stones, treatments can facilitate their passage or removal. Medications can also aid in stone dissolution and prevention.
If you experience recurrent ureteral stones, your healthcare provider can help identify the underlying causes. Based on their analysis, they can provide guidance on making lifestyle changes to prevent future stone formation.
When should I need medical assistance?
If you experience symptoms suggestive of ureteral stones, it is important to seek medical attention promptly. If the pain is severe and unmanageable, your healthcare provider may prescribe pain relievers and medications to alleviate nausea or vomiting.
A healthcare provider can help locate and diagnose ureteral stones, enabling appropriate treatment.
What questions should I ask my healthcare provider?
When consulting your healthcare provider about ureteral stones, consider asking the following questions:
- How can you confirm the presence of ureteral stones?
- If not ureteral stones, what alternative condition might be causing my symptoms?
- What type of ureteral stone do I have?
- What is the size and location of my ureteral stone?
- How many ureteral stones do I have?
- Is it likely that I will be able to pass the stone naturally, or will I require treatment?
- What treatment procedure would you recommend for eliminating my ureteral stone?
- How can I prevent the recurrence of ureteral stones?
- What dietary changes should I make?
- Are there any medications I should take to prevent future ureteral stones?
Ureteral Stones Treatment at Stonexpert
Ureteral Stones Treatment: Advanced Solutions from the Best Urologists at Stonexpert
At Stonexpert, we are proud to have an expert team of urologists & andrologists (Dr. Sunny Goel, Dr. Ram Niwas Yadav, and Dr. Amit Kumar Kundu) who specialize in treating ureteral stones. With years of experience and comprehensive knowledge in the field, our urologists are well-equipped to diagnose and design personalized treatment plans based on each patient’s unique needs. We prioritize your comfort and strive to provide excellent medical care throughout your journey.
Advanced Technology for Accurate Diagnosis
To ensure a precise diagnosis of ureteral stone cases, our experts rely on advanced imaging technologies such as CT scans or ultrasounds. These diagnostic tools allow us to identify the size, location, and composition of the stones accurately. This information plays a vital role in determining the most suitable course of treatment.
Non-Surgical Approaches: Minimizing Invasive Procedures
Whenever possible, we aim to provide non-surgical treatments for easier recovery and enhanced patient comfort. For smaller or more mobile stones within the lower urinary tract, Extracorporeal Shock Wave Lithotripsy (ESWL) may be recommended. ESWL uses high-frequency sound waves directed externally through the body without requiring any incisions or invasive procedures.
Minimally Invasive Surgical Options for More Complex Cases
In certain instances where non-surgical approaches may not be viable due to various factors like stone size or location within the upper urinary tract (ureters), minimally invasive surgical interventions become essential.
Comprehensive Care: Promoting Rapid Recovery
At Stonexpert, not only do we focus on effective treatment options, but we also prioritize your overall well-being throughout the entire process. Our team provides comprehensive care, from initial diagnosis to post-treatment follow-up consultations. We are committed to helping you recover swiftly while ensuring your comfort and satisfaction with our services.
Schedule a Consultation with Our Urologists Today!
If you suspect ureteral stones or have been experiencing symptoms such as severe pain in the abdomen or blood in the urine, don’t wait to seek professional help. Contact Stonexpert now to schedule an appointment with our exceptional urologists and gain access to innovative technology and personalized treatment plans tailored specifically for you. Trust us for compassionate care and advanced solutions that will help eliminate ureteral stones effectively while promoting your overall well-being.
