Common causes of the stone formation are:
- Supersaturation of urine by decreases intakes of water and or hot environmental condition where there is loss of body fluid in atmosphere by perspiration, and in breathing.
- Urine infection where crystals deposit themselves on and around the infection causing organism, and the stone grows over the period in the supersaturated urine.
- Diet rich in oxalates, Uric acid, can increase the incidence of stone formation.
- Functional or structural obstruction of the urinary system can precipitate the stone formation. Like Pelviureteric junction obstruction, Ectopic kidney, Horseshoe kidney.
The presentation of symptoms depends upon the location, size, and shape of the stone. Many times they are symptom free. They are called silent stones. Common symptoms are as follows:
- Sudden, severe pain- starting in the flanks and moving towards groins. Typically, described as ureteric colic and loin to groin pain
- Nausea and Vomiting.
- Blood in Urine.
- Increased Urinary frequency.
- Burning sensation on passing Urine.
- Infection in Urine.
Various factors play a role in the formation of kidney stone in a susceptible individual. These factors are diet, water intake, urinary output, climate, occupation, and heredity, radical and family background.
- Diet- Ingestion of excessive amount of calcium, oxalates, purines (uric acid), phosphates and other elements often results in excessive excretion of these components in the urine. The stone formation can be precipitated by high intake of calcium in the form of milk, ice creams, cheese, chocolates, cocoa, calcium containing drugs or vitamin D.
- Water Intake and Urinary Output- It has been well established that increased water intake and increased urinary output decrease the incidence of urinary stone in patients predisposed to the disease.
- Climate- High environmental temperature increases sweating, which may result in increased concentration of urine. This hyper concentration may contribute to stone formation.
- Occupation- Stone disease is more likely to be found in individuals with sedentary occupation like professionals and managerial class rather than unskilled and partly skilled labourers.
- Genetic Disorders- Like Gout, Cystinuria, primary Oxaluria, metabolic disorders like bowl, endocrine and kidney problems that increase blood and urine calcium and oxalates can promote the tendency for stone formation. Other rarer conditions like rickets, hyperparathyroidism and demineralization of bone may lead to stone formation.
- Obstruction and Infection- Due to stricture or enlarged prostate may cause stagnation of urine leading to stone formation. Chronic infection in the kidney may also allow stone formation around the debris in the urine.
Knowing the fact that you are harbouring the stone you should not ignore that. You should go for check up for the stone size every 6 months and should notice for increase in the size of the stone. Increase in size is the indication that stones need some intervention.
There is high chance of the repeated urinary tract infection because of the stone. Above all symptomatic obstructing stone can lead to kidney failure.
Lithotripsy is safest with above diseases as it is totally non-invasive procedure. However, one should keep these diseases under control when treating with Lithotripsy.
In general, you require surgical intervention if your stones are large enough to obstruct urine flow, if they are potentially harmful to your kidneys or if they are causing symptoms for which medication does not help.
Laparoscopic surgery is what is commonly known as key hole surgery. This is done by special instruments and a video – camera system, where the operation is done by seeing it on a TV screen.
This gives an enlarged view of structures and the operation can be done more cleanly. The surgeon’s hands remain outside, a long cut it not required for accommodating the surgeon’s hands.
Since the cut is small, the pain is minimized to a great extent. The cut sometimes is enlarged only for removal of organ or the part of it, which can be done by few centimeter incision. The cut for any open or conventional operation for kidney is about 15 to 25 centimeters. When repair of some defects is done, i.e. organ is not removed; the largest cut is not more than 1.5 cm.
The increased cost of equipments is compensated by
- saving on duration of hospital stay
- need for less medicines
For most kidney operations, laparoscopy has already become the operation of choice. These are –
- Removal of damaged kidney due to any cause, (Nephrectomy)
- Removal of kidney due to cancer
- Removal of part of kidney due to small cancer
- Correction of obstruction leading to swelling of kidney – Pyeloplasty for UPJ obstruction.
- Large Cysts
- Special situations for stone like large ureteric stone.
- Operation on adrenal gland
- Operation for Cancer Bladder and Cancer Prostate.
- Varicocoele operation in cases of male infertility.
- Reconstructive surgery on ureter or bladder.
It is a myth that disease / organ is left behind if done by laparoscopy.
In fact in most situations, the surgeon can do a better job due to improved and enlarged vision by the help of camera and screen. There is less bleeding so the operative area is cleaner. These factors add together for a more complete job.
Fortunately, today, most of the kidney operations can be done by this method. Laparoscopic surgery has replaced open surgery in many situations due to less morbidity i.e. the patients feel less sick for lesser duration.
This makes the experience of undergoing an operation less painful and more convenient. One can easily understand this by seeing the pictures of real patients who underwent laparoscopic operations.
Often, early stages of prostate cancer do not cause symptoms. But, in some cases, men with prostate cancer may experience any of these problems:
- A need to urinate frequently, especially at night;
- Difficulty starting urination or holding back urine;
- Weak or interrupted flow of urine;
- Painful or burning urination;
- Difficulty in having an erection;
- Painful ejaculation;
- Blood in urine or semen;
- Frequent pain or stiffness in the lower back, hips, or upper thighs.
You should speak with your doctor immediately if you have these symptoms or if you are over 50 and not had a recent prostate cancer screening. If you have a family history of prostate cancer you should consider screening beginning at age 45.
The first analysis many physicians will perform is a
- PSA test. Prostate specific antigen (PSA) is an enzyme produced in the prostate that is found in the seminal fluid and the bloodstream. To measure the PSA level, a small vial of blood is drawn and sent to a laboratory for evaluation. An elevated PSA level in the bloodstream does not necessarily indicate prostate cancer, since PSA can also be raised by infection or other prostate conditions. Many men with an elevated PSA do not have prostate cancer.
- The digital rectal exam (DRE) should be performed along with the PSA test. The DRE is performed by a physician who will insert a gloved finger into the rectum to feel the peripheral zone of the prostate where most prostate cancers occur. The physician will be checking for hardness of the prostate or for irregular shapes or bumps extending from the prostate – all of which may indicate a problem. The DRE is particularly useful because the PSA test may miss up to 25 percent of cancers, and the DRE may catch some of these.
There are a variety of ways to treat prostate cancer including
- Surgery to remove the prostate in its entirety, radiation therapy to kill the cancerous tissue in and around the prostate,
- Hormone deprivation therapy to stop the production of hormones that help prostate cancer cells to grow,
- Chemotherapy to stop the cancer cells from dividing and multiplying,
- “Watchful waiting” which involves no active treatment at that particular time. One or more of these treatment approaches may be used by your doctors at various times and stages of the disease. There are a variety of factors that will be evaluated by your physician to determine the best treatment approach.
Prostate gland is part of the male reproductive system. It is an organ about the size of a chestnut and consists of glandular and muscular tissue. It is situated below the neck of the bladder, encircling the urethra. The prostate produces a thin, milky, alkaline fluid that is secreted into the urethra at the time of emission of semen, providing an added medium for the life and motility of sperm. It is probable that prostatic fluid enhances fertility since the fluid flowing from the testes and seminal vesicles is acidic and sperm are not optimally mobile unless their medium is relatively alkaline.
Benign prostatic hyperplasia (BPH) is a condition that affects the prostate gland in men. The prostate is a gland found between the bladder (where urine is stored) and the urethra (the tube urine passes through). As men age, the prostate gland slowly grows bigger (or enlarges). As the prostate gets bigger, it may press on the urethra and cause the flow of urine to be slower and less forceful. “Benign” means the enlargement isnt caused by cancer or infection. “Hyperplasia” means enlargement.