Ureteral Stone

The ureteral stone is a deposit in the ureter. In most cases, a ureteral stone passes on its own.

What is a ureteral stone?

In medicine, the ureteral stone is also referred to as a ureteral stone . Ureteral stones are so-called concrements, i.e. solid masses that can be deposited, for example, in a hollow organ such as the ureter.

Such a calculus is called a ureteral stone, among other things, because it looks like a stone. Depending on the number and severity of ureteral stones and their location, the deposits in the ureter can cause mild to colicky pain.

Since damage to the urethral mucosa can occur due to the ureteral stone, slight bleeding occurs in some cases, which can be detected in the urine. Ureteral stones are equally common in women and men. The risk of developing ureteral stones increases with age.

Causes

A ureteral stone is often caused by urine that is too concentrated or by too high a concentration of certain substances in the body. Corresponding substances cannot dissolve in the urine and crystals form – like the ureteral stone.

Possible causes of an increased concentration of various substances and a subsequent ureteral stone are, for example, an unbalanced diet and/or existing metabolic diseases. Taking various medications can also promote the occurrence of ureteral stones.

Furthermore, a ureteral stone can be favored by existing inflammation of the urinary organs. Since the body of a healthy person produces substances that inhibit the development of a ureteral stone, another possible cause of calculus formation is a lack of the corresponding endogenous substances.

However, the causes underlying a ureteral stone cannot always be clearly clarified.

Symptoms, Ailments & Signs

Ureteral stones can cause quite different symptoms. Ureteral stones can remain completely symptom-free over a long period of time. Sometimes there are traces of blood in a laboratory examination of the urine, which, however, were not visible to the affected person with the naked eye. Blood in the urine, both visible and invisible, can be a first indication of a ureteral stone because, depending on its location and size, it causes injuries to the mucous membranes.

However, ureteral stones can also cause severe pain that requires immediate examination and treatment. This is especially the case when the ureteral stone starts to move and, for example, pushes itself across the ureter. A complete or partial prevention of the outflow of urine would be the result, which can lead to internal poisoning.

A transverse stone that blocks the ureter also causes severe pain in those affected. The pain is usually described as colicky and of almost unbearable intensity. Evidence of a ureteral stone is sometimes found as an incidental finding on ultrasound.

Depending on the size and location, further treatment must be discussed with a specialist, because large stones in particular can lead to colic. Small ureteral stones, which do not cause any discomfort to the person concerned, often go away on their own and can often be awaited without treatment under medical supervision.

Diagnosis & History

In order to diagnose a ureteral stone and its causes, a patient consultation is usually carried out first. In this conversation, the doctor treating you asks about a patient’s symptoms, for example; Questions can be asked about a red discoloration of the urine and/or a ureteral stone that has already occurred in the past.

A physical examination usually follows the medical history. In addition to blood and urine tests, X-rays or ultrasound images can be taken to show a ureteral stone.

If there is a ureteral stone, the course of the disease depends, among other things, on the size and position of the stone; smaller stones, for example, may pass on their own after a while with supportive measures (such as drinking enough water). If this does not happen, various therapeutic measures may become necessary.

Possible complications associated with a urinary tract stone include urinary tract inflammation; Corresponding pathogens can spread from here to the kidneys and/or blood. If the urine backs up into the kidneys due to a very large urinary tract stone, this can lead to severe kidney damage.

Complications

A ureteral stone blocks the outlet of the urine, which can accumulate as a result. This increases the risk of the urinary tract or the kidney becoming inflamed. In the worst case, the inflammation can spread systemically over the entire body and thus lead to sepsis. This can lead to multi-organ failure.

Furthermore, the urine can accumulate up to the kidneys, which can expand as a result and thus lead to a water sac kidney (hydronephrosis). In the course of this, the kidneys can fail (renal insufficiency), so that the quality of life of the affected person is severely impaired. The kidneys have problems excreting enough acids so that they accumulate in the body and over-acidify it.

The potassium ions are also no longer adequately excreted, which also accumulate and can lead to cardiac arrhythmia. In addition, not enough water is excreted. This remains in the blood and the heart has to do more work, blood pressure rises. Over the long term, this can result in atherosclerosis. In addition, increased edema is observed because more water is pressed from the blood into the tissue.

In the worst cases, the kidney can no longer contribute to the patient’s life support, so that the patient has to undergo dialysis or a new kidney has to be transplanted.

When should you go to the doctor?

Since a ureteral stone is usually associated with severe pain and other unpleasant symptoms, a doctor should always be consulted. A visit to the doctor is necessary if the patient suffers from severe pain when urinating.

This pain is burning or stabbing and can have a very negative effect on the sufferer’s quality of life. Pain in the kidneys or flanks can also indicate a ureteral stone and should be examined. Often there is also a red discoloration of the urine due to the admixture of blood.

Nausea can also indicate a ureteral stone and should always be investigated if it occurs with painful urination. If the ureteral stone is not treated, it can lead to kidney damage in the worst case.

A ureteral stone is treated by a urologist. An early diagnosis can quickly lead to a positive course of the disease without complications. In serious cases or if the pain is very severe, you can also go to the hospital.

Treatment & Therapy

Colic pain associated with a ureteral stone can be treated symptomatically with analgesic or antispasmodic drugs; such painkillers can, for example, be injected into the vein of an affected person.

If a ureteral stone does not pass on its own or with the help of the administration of large amounts of fluid, special medication can lead to the stone passing in some cases. Further treatment options are to break up a large ureteral stone using various methods.

The resulting smaller pieces of ureteral stone then usually pass on their own. In the case of a ureteral stone that is no larger than approx. 2.5 centimetres, a corresponding external fragmentation can usually be carried out using ultrasound waves.

If this procedure is not possible, various other methods of crushing are available, in which devices are inserted into the ureter.

If the procedures mentioned remain successful or if they are not possible, a last therapeutic step is to remove the ureteral stone with the help of an operation.

Outlook & Forecast

The prognosis of a ureteral stone is favorable. Spontaneous healing can be documented in most patients, since the substances that have become stuck in their bodies are released and transported away on their own. Due to the possibilities described, treatment is not always necessary. The targeted supply of liquids can already bring about a solution of a ureteral stone and thus initiate recovery.

The deposited crystals can develop different sizes. These are responsible for the occurrence of possible complications. In severe cases, pain and inflammation occur. If the patient has a weakened immune system, healing may be delayed. The inflammation can spread and trigger a deterioration in general health.

Medical care is necessary so that the organism can provide sufficient defenses. In rare cases, an operation is necessary. The ureteral stone is completely removed and the patient is then discharged from the treatment as cured.

A new formation of the ureteral stone is possible in the course of life. People with an unhealthy lifestyle are particularly at risk. The prognosis remains good if the symptoms return. The sooner the foreign body is noticed, the lower the risk of removing it. In the long term, however, a change in eating habits is recommended to avoid a relapse.

Prevention

In order to prevent a ureteral stone, doctors first recommend general preventive measures such as drinking enough fluids (approx. 2 to 4 liters per day) and not eating too much salt. Since ureteral stones are more common in overweight people, preventive weight reduction can make sense. If medically advisable, a ureteral stone can also be prevented with medication.

Aftercare

After the urinary stones have been excreted, the aftercare measures must be decided individually. Urinary stone disease occurs again in around 50 to 70 percent of cases. Regular medical follow-ups are therefore necessary. As part of the check-up, the doctor will prepare a metabolic diagnosis and for this purpose, among other things, take urine and carry out a physical examination.

In the case of chronic conditions, an excreted ureteral stone can be used for analysis. A stone analysis and other basic diagnostic measures are used to determine any health problems. The typical urine diagnosis is carried out using a urine test strip. The doctor checks, among other things, the cystine, uric acid and Struvi levels.

If there are deviations from the norm, medication can be prescribed to prevent the development of another ureteral stone. In the case of a positive course without chronic diseases, the frequency of the follow-up examinations can be reduced. If chronic metabolic disorders are present, a monthly frequency makes sense. The first follow-up check takes place at the earliest four weeks after the initial treatment of the stone disease.

A previous examination only provides information about the immediate development after therapy, but not about the long-term prospects. The patient should, if necessary, consult other physicians as part of the follow-up care. Follow-up care is provided by your family doctor or a urologist. In the case of chronic diseases, the responsible specialist must also be involved in the follow-up examinations.

You can do that yourself

Ureteral stones should always be treated by a doctor. Various home remedies and self-help measures are available to accompany medical treatment. Those affected should first drink enough – at least three liters a day – and move around a lot. The stone can usually be loosened and flushed out quickly through physical activity and physiotherapy . Climbing stairs regularly is considered a particularly effective measure for ureteral or kidney stones.

If this has no effect, food and dietary supplements with a lot of magnesium may help. An alternative natural remedy is dandelion. Taken in the form of tea, the diuretic supports the passage of ureteral stones and also promotes kidney blood flow. A low-meat and low-fat diet should be supported.

Above all, calcium, which is contained in milk and dairy products, should be avoided in acute ureteral stones. The same applies to rhubarb, chard, spinach and other foods with oxalic acid, as well as foods that contain too much sugar and salt.

If these measures have no effect, it is important to consult a doctor and have the stones treated medically. Classic painkillers such as ibuprofen or metamizol help against the pain, but also natural painkillers from nature.

Ureteral Stone