What is Ureter Stone? Ureteral Stone Symptoms and Surgery

by Abbas Jahangir · June 22, 2024

Ureteral stone is a health problem that can cause obstruction of the urinary tract. When ureteral stones are not excreted with urine, they can cause health problems such as urinary tract infection.

What is Ureter Stone?

What does ureteral stone mean? To answer this question, it is necessary to first understand what the ureter is. The ureter is a thin tube-shaped structure that connects the kidneys and bladder. In humans, there are two ureters, one between the right kidney and bladder and the other between the left kidney and bladder.

Stones formed in the kidney are called ureteral stones when they pass through the urinary tract and into the ureter. These stones can sometimes get stuck in the thin ureter and cause obstruction. Obstruction in the ureter causes serious symptoms in patients. Different approaches can be applied to patients depending on the size and location of the ureteral stone.

Kidney stones are formed by clusters of crystalline minerals. Although stones usually form in the kidney, they can also develop in organs such as the ureter and bladder in the urinary tract.

Ureteral stones usually occur when stones that have already formed in the kidney pass into the ureter with urine. Very small stones can be excreted with urine without causing any symptoms in the person. However, large stones can get stuck in the ureter and block the flow of urine.

Ureteric stones are formed as a result of crystallization of minerals. The crystals that make up stones can originate from different minerals and molecules. In the light of this information, the causes of ureteral stones can be listed as follows:

Calcium:Stones composed of calcium oxalate crystals are the most common ureteral stones. Not consuming enough fluids or eating a diet rich in foods containing high amounts of oxalates (tea bags, strawberries, spinach, chocolate), consuming foods containing high protein (red meat) and taking calcium supplements increase the risk of calcium stones.
Uric Acid:Urine being too acidic paves the way for the development of uric acid stones. Uric acid stones are more common in men and people with gout.
Struvite:Struvite stones may occur in those who experience chronic urinary tract infections. These stones occur especially in women who have frequent urinary tract infections.
Cystine:It usually appears in children. The genetic structure of the child should be examined. Cystine stones may be seen in people with a genetic disease called cystinuria. Cystine is an amino acid, and in cystinuria, cystine leaks from the kidneys into the urine. Cystins in the urine can form stones over time. Cystine stones are one of the rarest types of ureteral stones. Some factors may increase a person’s risk of developing ureteral stones. These risk factors can be listed as follows:
Family History:People whose parents or siblings have had ureteral stone problems are more likely to develop stones.
Dehydration (Inadequate Fluid Intake):People who do not drink enough water produce less concentrated urine. The urine volume must be large so that the minerals do not come together and crystallize. Therefore, the risk of developing ureteral stones increases in people with low fluid intake.
Nutrition:Salty foods and animal protein sources may contribute to the formation of ureteral stones. Foods containing high amounts of oxalates, such as spinach, tea, chocolate and hazelnuts, can also cause ureteral stones.
Some Medicines:A group of medicines including decongestants (nasal congestion relievers), diuretics, steroids and anticonvulsants; It increases the risk of ureteral stones.
Some Medical Conditions:Medical conditions such as urinary tract obstruction, inflammatory bowel disease, gout, hyperparathyroidism, obesity, and recurrent urinary tract infections may predispose to the development of ureteral stones.

What are the Symptoms of Ureteral Stones?

Ureteral stone symptoms may vary depending on the size of the stone and its location in the ureter. The most common ureteral stone symptoms are as follows:

Pain in the lower abdomen or flank pain
Pain and burning sensation when urinating
Seeing blood in the urine
Feeling the need to urinate frequently
Nausea, vomiting
Fire

Ureteral stone pain can be mild and more aching, or it can be quite severe and unbearable. The feeling of pain may ease or intensify from time to time. Abdominal or side pain caused by ureteral stones may also occur in other parts of the body.

Ureteral stones can lead to urinary tract infection. In this case, in addition to the above, the patient may experience symptoms such as foul-smelling urine, turbidity in the urine, and a sudden feeling of urination.

How to Diagnose Ureteral Stone?

A patient who consults a doctor with complaints of pain in the lower abdomen, side pain or bloody urine is subjected to some tests on suspicion of stones.

After the patient’s complaints are listened to and examined, it is time for a urinalysis. Urine test; It is performed to detect small, invisible bleeding in the urine, to investigate the presence of a urinary tract infection, and to examine minerals that may cause stone formation in the urine.

Imaging methods are also used in the diagnosis of ureteral stones. Ultrasound method can be used to visualize the stone in the ureter. Ultrasound is a method used to show structures inside the body using sound waves and does not contain radiation. Therefore, ultrasound can be easily used in patients with suspected ureteral stones.

Computed Tomography (CT) is the method that gives the best results in showing ureteral stones. CT provides detailed imaging of the abdomen and pelvis. In this way, the location of the stone within the ureter can be clearly determined. Changes caused by the stone in the urinary tract can also be noticed with CT. For example, a right ureter lower end stone may cause enlargement of the right ureter and right kidney, which are above the section where it is stuck. Left ureter lower end stone affects the left ureter and left kidney in the same way.

How is Ureteral Stone Surgery Performed?

Many ureteral stones are eliminated from the body through urine without needing treatment. So how to pass ureteral stone? There are some practices that enable ureteral stones to be expelled from the body more easily. The most important way to reduce ureteral stones is to consume plenty of fluids. Cranberries and blueberries are thought to protect the urinary system.

Ureteric stones that cause conditions such as fever and infection in the patient need to be treated. There are various treatment methods that can be applied for large size stones that do not pass from the ureter on their own.

Stent Placement in the Ureter: In this procedure, a small plastic tube is placed in the area where the stone is stuck in the ureter. Thanks to the placed tube, the stone can pass through the ureter. Stent placement in the ureter is a procedure and is usually done under anesthesia.

Nephrostomy Tube Placement: In this method, a tube is inserted into the kidney and urine is removed from the body. A nephrostomy tube is placed if conditions such as fever and infection occur due to obstruction in the urinary tract. Thus, the urine accumulated in the kidney is excreted and the patient’s symptoms may be relieved.

Shock Wave Lithotripsy: Shock wave lithotripsy uses sound waves to break the ureteral stone into small pieces. The smaller stone pieces can easily pass through the urinary tract.

Ureteroscopy: In this method, also known as endoscopic ureteral stone surgery, the doctor advances a thin tube-shaped structure through the patient’s urethra (where urine comes out) into the body. After the urethra, the tube comes to the bladder and ureter, respectively. When the stone in the ureter is reached, the stone is broken into small pieces using a laser. In this way, the smaller stone pieces are excreted out of the body with urine.

Percutaneous Nephrolithotomy: This procedure is often used to treat stones that are quite large or have an unusual shape. A small incision is made to the patient at the level of the kidney on the side where the stone is located. The stone is removed with the nephroscope advanced into the body through this incision. Percutaneous nephrolithotomy is a procedure performed under general anesthesia.

The doctor may prescribe painkillers to the patient for pain after ureteral stone surgery. Depending on the patient’s general condition, he or she may be discharged from the hospital on the same day as the surgery. Some patients may need to stay in the hospital for a few days due to complications after ureteral stone surgery.

Ureteric stones that block urine flow for a long time can impair kidney functions. Therefore, ureter stone; A doctor should be consulted when it causes symptoms such as fever, bloody urine, and severe pain. Ureteral stone treatment is a situation that should not be neglected.