Ureteral Stones, also known as ureterolithiasis, are hard deposits made of minerals and salts that form in the kidneys and travel down the ureters. These stones can vary in size and composition, including calcium oxalate, uric acid, struvite, and cystine stones. They can cause obstruction and irritation in the urinary tract, leading to severe pain and other complications.
Clinical Evaluation
Patient History: Review of symptoms, previous history of kidney stones, dietary habits, and fluid intake.
Physical Examination: Examination to identify signs of pain, especially in the lower back and abdomen.
Diagnostic Tests
Urinalysis: Examination of urine for blood, crystals, or signs of infection.
Blood Tests: To check for levels of calcium, uric acid, and kidney function indicators.
Imaging Studies:
Non-contrast Helical CT Scan: The gold standard for detecting ureteral stones.
Ultrasound: Useful for detecting stones and evaluating kidney function, especially in pregnant women.
Intravenous Pyelogram (IVP): X-ray of the urinary tract after injecting contrast dye to highlight stones.
Abdominal X-ray: Can detect some types of stones, though less sensitive than a CT scan.
Severe, sharp pain in the side and back, below the ribs.
Pain that radiates to the lower abdomen and groin.
Pain that comes in waves and fluctuates in intensity.
Pain during urination.
Pink, red, or brown urine (hematuria).
Cloudy or foul-smelling urine.
Nausea and vomiting.
Persistent urge to urinate, frequent urination, or urinating in small amounts.
Fever and chills if an infection is present.
Treatment for ureteral stones depends on the size, location, and composition of the stones, as well as the severity of symptoms.
Hydration: Increasing fluid intake to help flush out the stones through urine.
Pain Management: Over-the-counter pain relievers such as ibuprofen or prescription pain medications.
Medical Expulsion Therapy: Medications like alpha blockers (e.g., tamsulosin) to relax the muscles in the ureter and help pass the stone.
Extracorporeal Shock Wave Lithotripsy (ESWL): Non-invasive procedure using shock waves to break the stone into smaller pieces that can be passed in the urine.
Ureteroscopy: A thin scope inserted through the urethra and bladder into the ureter to locate and remove or break up the stone.
Percutaneous Nephrolithotomy: Surgical procedure to remove large or complex stones directly from the kidney using a small incision in the back.
Prevention: Dietary changes, medications, and lifestyle modifications to reduce the risk of future stone formation.