Lithiasis of the Urinary System. Causes, Diagnosis and Treatment.

The frequency of urolithiasis has been increasing in recent decades. The incidence of nephrolithiasis is estimated at about 2-4% of the population.

There are two theories about how stones are formed. According to the theory of the uterus, organic substances are eliminated from the kidneys, on which the salts of the urine settle and thus the stones are created.

According to the theory of crystallization when there is oversaturation of urine with ions of calcium, magnesium, phosphate, oxalate, etc. immediate crystallization and stone formation takes place. The causes that lead to the formation of stones can be due to factors that are located before the kidneys, inside the kidneys themselves or after them (pre-renal, renal and post-renal factors).

Prerenal factors are diet, immobility, hyperparathyroidism and hyperuricemia. Renal agents are idiopathic hypercalciuria, cystinuria and tubular acidosis. Post-renal factors are urinary tract disorders and urinary tract infections.
The stone first forms inside the calyx and usually increases in size. As long as the stone remains in the calyx it does not cause discomfort and is characterized as a dumb stone. The same happens if the stone is in the renal pelvis.

If the calyx stone gets stuck in his neck or the pelvic stone passes into the ureter, colic of the kidney is caused. Renal colic is an acute pain that arises primarily due to the stagnation of urine in the kidney. This posture leads to dilation of the pelvic floor system. This dilatation is to some extent reversible over time and only causes temporary kidney dysfunction. However, if the dilation persists for more than 2-3 weeks, there is a risk of losing kidney function.

Renal colic is an acute pain that arises primarily due to the stagnation of urine in the kidney. Colic is a pain in the lower back if the stone is stuck in the upper part of the ureter. If the stone is in the middle of the ureter it reflects the pain in the lower abdomen and when it is in the lower part of the ureter it reflects in the external genitalia. Colic also causes a tendency to vomit, flatulence and sometimes reflex ileus.

The diagnosis of colic is made clinically, in the general examination of urine there is microhematuria, many times we have macrohematuria. Ultrasound shows dilation of the pelvic system and plain X-ray shows if there are any calcifications.

Antispasmodics and analgesic are administered intravenously for the treatment of colic.