![]() ![]() Although the old adage is that stone passage is very painful, often likened to childbirth, this is not always true. Stone passage presents itself in many ways. A stone can be found as a result of a workup of hematuria, or blood in the urine, or a stone can be found when it decides to pass. A patient may undergo a radiologic exam for an unrelated reason when a stone is found incidentally. Stones are discovered in one of three ways. One of the first things an Urologist will want to determine is whether a uric acid stone is suspected or not when a stone is present as this may affect how that stone will be managed. What is unique about uric acid stones is that they can, if not coated with calcium, be dissolved by raising the pH of the urine. These stones can form spontaneously, but can also be a result of high blood uric acid levels, a condition that can also cause a disease called gout. On the contrary, uric acid stones comprise perhaps 10% of all stones. These stones cannot be dissolved, and must either pass or be treated. If a stone can be seen on a plain x-ray, it is a calcium stone. The vast majority of stones are calcium stones, either calcium oxalate or calcium phosphate. On the contrary, uric acid stones comprise perhaps 10% of all stones, which if not coated with calcium, can be dissolved by raising the pH of the urine. For most cases however, the key to stone prevention is simply increasing water intake. If such an abnormality is suspected, special test will be performed and chronic medication may be prescribed. However, some patients will have specific metabolic abnormalities or hormonal abnormalities that predispose them to stone formation. The most common factor contributing to kidney stone formation is inadequate water intake, which many/most of us are guilty of. Unlike years past where urinary stones were often managed with open surgery, today stones that do not pass on their own are nearly always treated in a minimally invasive fashion. Another very common problem seen in an Urologist’s office, particularly here in the Mid-Atlantic and Southeastern United States (sometimes referred to as the “stone belt”) is kidney stones. ![]()
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