A kidney stone can move from the kidney and become lodged inside the ureter, which can block the flow of urine, as well as cause a sharp cramp in the back, side, or lower abdomen. Pain often comes in waves lasting up to two hours, then subsides, called renal colic. The affected kidney could then develop hydronephrosis, should a part of the kidney become swollen due to blocked flow of urine. It is classically described that there are three sites in the ureter where a kidney stone will commonly become stuck: where the ureter meets the renal pelvis; where the iliac blood vessels cross the ureters; and where the ureters enter the urinary bladder, however a retrospective case study, which is a primary source, of where stones lodged based on medical imaging did not show many stones at the place where the iliac blood vessels cross.
Ureteral stones
Ureter
Ureter | Ureteral stones
Sorry. I cannot find the answer based on the context. Sorry. I cannot find the answer based on the context. Calcium oxalate and calcium phosphate A kidney stone can move from the kidney and become lodged inside the ureter
what tissue types form the wall of the ureter
user
urothelial cells
assistant
what is ureter?
user
The ureters are tubes made of smooth muscle that propel urine from the kidneys to the urinary bladder.
assistant
what is the size of this tube?
user
The ureters are between 1.5 - 6 mm in diameter, and surrounded by a layer of smooth muscle for 1 - 2 cm near their ends just before they enter the bladder.
assistant
can you name one function of this bladder?
user
Urine, excreted by the kidneys, collects in the bladder
assistant
do mammals also have this bladder?
user
Yes, all mammals have a urinary bladder
assistant
is it also prone to any deadly disease?
user
Yes, bladder cancer
assistant
does the tube also have anything to do with the supply of blood?
user
Yes, the arteries which supply the ureter vary along its course
assistant
do stones also form here?
user
Yes, a kidney stone can move from the kidney and become lodged inside the ureter
assistant
and what causes this stone to form in this tube?
user
A kidney stone can move from the kidney and become lodged inside the ureter, which can block the flow of urine, as well as cause a sharp cramp in the back, side, or lower abdomen. Pain often comes in waves lasting up to two hours, then subsides, called renal colic. The affected kidney could then develop hydronephrosis, should a part of the kidney become swollen due to blocked flow of urine. It is classically described that there are three sites in the ureter where a kidney stone will commonly become stuck: where the ureter meets the renal pelvis; where the iliac blood vessels cross the ureters; and where the ureters enter the urinary bladder, however a retrospective case study, which is a primary source, of where stones lodged based on medical imaging did not show many stones at the place where the iliac blood vessels cross.
Ureter | Ureteral stones
Hyperechoic stones are seen with accompanying posterior shadowing. Additional twinkling artifacts below the stone can often be seen using Doppler US. Large stones filling the entire collecting system are called coral stones or staghorn calculi and are easily visualized with US (Figure 20). Stones in the ureters are usually not visualized with US due to the air-filled intestines obscuring the insonation window. However, ureteral stones near the ostium can be visualized with a scan position over the bladder. An exam of the ureteric orifices and the excretion of urine to the bladder can be performed by inspecting the ureteric jets in the bladder with color Doppler US.
Renal ultrasonography | Kidney stone disease
Most stones are compounds containing calcium such as calcium oxalate and calcium phosphate. The first recommended investigation is a CT scan of the abdomen because it can detect almost all stones. Management includes analgesia, often with nonsteroidal antiinflammatories. Small stones (< 4mm) may pass themselves; larger stones may require lithotripsy, and those with complications such as hydronephrosis or infection may require surgery to remove.
Ureter | Ureteral stones
If a patient has a stone lodged higher in the urinary tract, the physician may use a much finer calibre scope called a ureteroscope through the bladder and up into the ureter. (The ureter is the tube that carries urine from the kidney to the bladder.) The physician can then see the stone and remove it with a small basket at the end of a wire that is inserted through an extra tube in the ureteroscope. For larger stones, the physician may also use the extra tube in the ureteroscope to extend a flexible fiber that carries a laser beam to break the stone into smaller pieces that can then pass out of the body in the urine.
Cystoscopy | Male and female urinary tracts
Many other complications arise from ureteroceles. Redundant collection systems are usually smaller in diameter than single, and predispose the patient to impassable kidney stones. The effective "bladder within a bladder" compounds this problem by increasing the collision of uric acid particles, the process by which uric acid stones are formed. Ureterocele is also associated with poor kidney function. It can cause frequent blockage of the ureter leading to serious kidney damage. In other cases, a small, upper portion of the kidney is congenitally non-functional. Though often benign, this problem can necessitate the removal of non-functioning parts.
Ureterocele | Complications
When they do not dissolve correctly and further build up, they will commonly lodge themselves in the urinary tract and in this case, are usually small enough to pass through urine. In extreme situations, however, these stones may lodge themselves within the tube that connects the kidney and the bladder, called the ureter. In this case, they become very large in size and will most likely cause great pain, bleeding, and possibly even block the flow of urine. These can occur in both men and women, and studies show that around 12% of men, and 8% of women in America will develop kidney stones within their lifetime.
Excretory system | Kidney Stones
Finally, a kidney stone may travel down the ureter into the bladder and become a bladder stone. There is some evidence indicating that chronic irritation of the bladder by retained stones may increase the chance of bladder cancer. Urinary schistosomiasis, a disease caused by the digenean trematode "Schistosoma haematobium", has been implicated in the development of vesical calculi. However, evidence accumulated thus far has not supported this hypothesis.
Bladder stone | Causes
As noted above (section on calcium oxalate stones), people with inflammatory bowel disease (Crohn's disease, ulcerative colitis) tend to have hyperoxaluria and form oxalate stones. They also have a tendency to form urate stones. Urate stones are especially common after colon resection. Uric acid stones appear as pleomorphic crystals, usually diamond-shaped. They may also look like squares or rods which are polarizable.
Kidney stone disease | Uric acid stones
Ureteroscopy has become increasingly popular as flexible and rigid fiberoptic ureteroscopes have become smaller. One ureteroscopic technique involves the placement of a ureteral stent (a small tube extending from the bladder, up the ureter and into the kidney) to provide immediate relief of an obstructed kidney. Stent placement can be useful for saving a kidney at risk for postrenal acute kidney failure due to the increased hydrostatic pressure, swelling and infection (pyelonephritis and pyonephrosis) caused by an obstructing stone. Ureteral stents vary in length from and most have a shape commonly referred to as a "double-J" or "double pigtail", because of the curl at both ends.
Kidney stone disease | Ureteroscopic surgery
Urolithiasis refers to stones originating anywhere in the urinary system, including the kidneys and bladder. Nephrolithiasis refers to the presence of such stones in the kidneys. Calyceal calculi are aggregations in either the minor or major calyx, parts of the kidney that pass urine into the ureter (the tube connecting the kidneys to the urinary bladder). The condition is called ureterolithiasis when a calculus is located in the ureter. Stones may also form or pass into the bladder, a condition referred to as bladder stones.
Kidney stone disease | Location
Postrenal azotemia and hydronephrosis can be observed following the obstruction of urine flow through one or both ureters. Pain in the lower-left quadrant can sometimes be confused with diverticulitis because the sigmoid colon overlaps the ureter, and the exact location of the pain may be difficult to isolate due to the proximity of these two structures.
Kidney stone disease | Signs and symptoms
Bladder stones may occur whenever the kidneys, bladder, or ureters become inflamed, which may occur when the urine becomes too concentrated or when the body becomes dehydrated. Minerals such as calcium and magnesium crystallize into the stones, which then can cause such symptoms as lower back or abdominal pain or difficulty with urination. The use of urinary catheters may cause a bladder stone. Individuals who are paralyzed or are unable to adequately pass urine may require the use of small plastic tubes (catheters) placed into the bladder. The use of these tubes may lead to an infection, which irritates the bladder, resulting in stone formation.
Bladder stone | Causes
Urinary stones may be composed of the following substances:
Bladder stone | Classification
Kidney stones can form through deposits of sodium urate microcrystals. Saturation levels of uric acid in blood may result in one form of kidney stones when the urate crystallizes in the kidney. These uric acid stones are radiolucent and so do not appear on an abdominal plain X-ray. Uric acid crystals can also promote the formation of calcium oxalate stones, acting as "seed crystals".
Uric acid | Uric acid stone formation
Larger stones may require surgical intervention for their removal, such as shockwave lithotripsy, ureteroscopy or percutaneous nephrolithotomy. Patients can also be treated with alpha blockers in cases where the stone is located in the ureter.
Renal colic | Treatment
3–20% of people who form kidney stones have medullary sponge kidney.
Kidney stone disease | Risk factors
Some 60% of all renal stones are radiopaque. In general, calcium phosphate stones have the greatest density, followed by calcium oxalate and magnesium ammonium phosphate stones. Cystine calculi are only faintly radiodense, while uric acid stones are usually entirely radiolucent. Where a CT scan is unavailable, an intravenous pyelogram may be performed to help confirm the diagnosis of urolithiasis. This involves intravenous injection of a contrast agent followed by a KUB film. Uroliths present in the kidneys, ureters, or bladder may be better defined by the use of this contrast agent. Stones can also be detected by a retrograde pyelogram, where a similar contrast agent is injected directly into the distal ostium of the ureter (where the ureter terminates as it enters the bladder).
Kidney stone disease | Imaging studies
Stone size influences the rate of spontaneous stone passage. For example, up to 98% of small stones (less than in diameter) may pass spontaneously through urination within four weeks of the onset of symptoms, but for larger stones ( in diameter), the rate of spontaneous passage decreases to less than 53%. Initial stone location also influences the likelihood of spontaneous stone passage. Rates increase from 48% for stones located in the proximal ureter to 79% for stones located at the vesicoureteric junction, regardless of stone size. Assuming no high-grade obstruction or associated infection is found in the urinary tract, and symptoms are relatively mild, various nonsurgical measures can be used to encourage the passage of a stone.
Kidney stone disease | Treatment
Renal colic is a type of abdominal pain commonly caused by obstruction of ureter from dislodged kidney stones. The most frequent site of obstruction is the vesico-ureteric junction (VUJ), the narrowest point of the upper urinary tract. Acute obstruction and the resultant urinary stasis (disruption of urine flow) can distend the ureter (hydroureter) and cause a reflexive peristaltic smooth muscle spasm, which leads to a very intense visceral pain transmitted via the ureteric plexus.
Renal colic | Introduction
Blockage, or obstruction of the ureter can occur, as a result of narrowing within the ureter, or compression or fibrosis of structures around the ureter. Narrowing can result of ureteric stones, masses associated with cancer, and other lesions such as endometriosis tuberculosis and schistosomiasis. Things outside the ureters such as constipation and retroperitoneal fibrosis can also compress them. Some congenital abnormalities can also result in narrowing or the ureters. Congenital disorders of the ureter and urinary tract affect 10% of infants. These include partial or total duplication of the ureter (a duplex ureter), or the formation of a second irregularly placed () ureter; or where the junction with the bladder is malformed or a ureterocoele develops (usually in that location).
Ureter | Anatomical and surgical abnormalities
When nerves to the back are damaged, the bladder cannot empty, resulting in stagnant urine.
Bladder stone | Signs and symptoms
Passage of kidney stones through the urethra can be painful. Damage to the urethra, such as by kidney stones, chronic infection, cancer, or from catheterisation, can lead to narrowing, called a urethral stricture. The location and structure of the narrowing can be investigated with a medical imaging scan in which dye is injected through the urinary meatus into the urethra, called a retrograde urethrogram. Additional forms of imaging, such as ultrasound, computed tomography and magnetic resonance imaging may also be used to provide further details. Injuries to the urethra (e.g., from a pelvic fracture) Foreign bodies in the urethra are uncommon, but there have been medical case reports of self-inflicted injuries, a result of insertion of foreign bodies into the urethra such as an electrical wire.
Urethra | Injury
Kidney stones have been identified and recorded about as long as written historical records exist. The urinary tract including the ureters, as well as their function to drain urine from the kidneys, has been described by Galen in the second century AD. The first to examine the ureter through an internal approach, called ureteroscopy, rather than surgery was Hampton Young in 1929. This was improved on by VF Marshall who is the first published use of a flexible endoscope based on fiber optics, which occurred in 1964. The insertion of a drainage tube into the renal pelvis, bypassing the uterers and urinary tract, called nephrostomy], was first described in 1941.
Kidney | History
Throughout the books of the Hippocratic Corpus, there are varying hypotheses as to reasons why and exactly how urinary tract stones actually formed. It is noted that these hypotheses were all based on the use of uroscopy and observation of patients by doctors of the time.
Hippocratic Corpus | Stone Formation Theories
Several factors contribute to the formation of renal stones in space. Dietary changes, bone metabolism, dehydration, increased salt intake as well as decreased urine volumes and increased urine saturation are all possible causes of renal stone formation. It has been noted that spaceflight-induced changes in urine biochemistry are conducive for stone formation. Other possible causes include: The most common renal stone is calcium oxalate and is usually caused by treatable metabolic disorders of hypercalcuria (increased calcium levels in the urine). These stones cause pain with passage and blockage and have been known to recur.
Renal stone formation in space | Causes
Kidney stone disease, also known as nephrolithiasis or urolithiasis, is when a solid piece of material (kidney stone) develops in the urinary tract. Kidney stones typically form in the kidney and leave the body in the urine stream. A small stone may pass without causing symptoms. If a stone grows to more than , it can cause blockage of the ureter, resulting in severe pain in the lower back or abdomen. A stone may also result in blood in the urine, vomiting, or painful urination. About half of people who have had a kidney stone will have another within ten years.
Kidney stone disease | Introduction
More invasive forms of imaging include ureteroscopy, which is the insertion of a flexible endoscope into the urinary tract to view the ureters. Ureteroscopy is most commonly used for medium to large-sized stones when less invasive methods of removal are not able to be used.
Ureter | Imaging
Although all types of urinary stones can potentially form staghorn calculi, approximately 75% are composed of a struvite-carbonate-apatite matrix.
Struvite | Struvite kidney stones
About 10–15% of urinary calculi are composed of struvite (ammonium magnesium phosphate, NHMgPO·6HO). Struvite stones (also known as "infection stones," urease, or triple-phosphate stones) form most often in the presence of infection by urea-splitting bacteria. Using the enzyme urease, these organisms metabolize urea into ammonia and carbon dioxide. This alkalinizes the urine, resulting in favorable conditions for the formation of struvite stones. "Proteus mirabilis", "Proteus vulgaris", and "Morganella morganii" are the most common organisms isolated; less common organisms include "Ureaplasma urealyticum" and some species of "Providencia", "Klebsiella", "Serratia", and "Enterobacter". These infection stones are commonly observed in people who have factors that predispose them to urinary tract infections, such as those with spinal cord injury and other forms of neurogenic bladder, ileal conduit urinary diversion, vesicoureteral reflux, and obstructive uropathies.
Kidney stone disease | Struvite stones
Following this, in the 19th and 20th centuries multiple terms relating to the structures such as ureteritis and ureterography, were coined. Kidney stones have been identified and recorded about as long as written historical records exist. The urinary tract including the ureters, as well as their function to drain urine from the kidneys, has been described by Galen in the second century AD. The first to examine the ureter through an internal approach, called ureteroscopy, rather than surgery was Hampton Young in 1929. This was improved on by VF Marshall who is the first published use of a flexible endoscope based on fiber optics, which occurred in 1964.
Ureter | History
Lithiasis (stone formation) in the bladder is called cystolithiasis (), from "cysto-" (bladder/cyst) + "-lith" (stone) + "-iasis" (disorder).
Bladder stone | Etymology
The ureters are tubes made of smooth muscle that propel urine from the kidneys to the urinary bladder. In the human adult, the ureters are usually long and around in diameter. The ureter is lined by urothelial cells, a type of transitional epithelium, and has an additional smooth muscle layer in third closest to the bladder that assists with peristalsis. The ureters can be affected by a number of diseases; including urinary tract infections and kidney stone. is when a ureter is narrowed, due to for example chronic inflammation. Congenital abnormalities that affect the ureters can include the development of two ureters on the same side, or abnormally placed ureters.
Ureter | Introduction
Sensation supplied is sparse close to the kidneys and increases closer to the bladder. Sensation to the ureters is provided by nerves that come from T11 - L2 segments of the spinal cord. When pain is caused, for example by spasm of the ureters or by a stone, the pain may be referred to the dermatomes of T11 - L2, namely the back and sides of the abdomen, the scrotum (males) or labia majora (females) and upper part of the front of the thigh.
Ureter | Nerve supply
They are designed to allow urine to flow past an obstruction in the ureter. They may be retained in the ureter for days to weeks as infections resolve and as stones are dissolved or fragmented by ESWL or by some other treatment. The stents dilate the ureters, which can facilitate instrumentation, and they also provide a clear landmark to aid in the visualization of the ureters and any associated stones on radiographic examinations. The presence of indwelling ureteral stents may cause minimal to moderate discomfort, frequency or urgency incontinence, and infection, which in general resolves on removal. Most ureteral stents can be removed cystoscopically during an office visit under topical anesthesia after resolution of urolithiasis.
Kidney stone disease | Ureteroscopic surgery
If a kidney stone is suspected (e.g. on the basis of characteristic colicky pain or the presence of a disproportionate amount of blood in the urine), a kidneys, ureters, and bladder x-ray (KUB film) may assist in identifying radioopaque stones. Where available, a noncontrast helical CT scan with 5millimeter sections is the diagnostic modality of choice in the radiographic evaluation of suspected nephrolithiasis. All stones are detectable on CT scans except very rare stones composed of certain drug residues in the urine. In patients with recurrent ascending urinary tract infections, it may be necessary to exclude an anatomical abnormality, such as vesicoureteral reflux or polycystic kidney disease.
Pyelonephritis | Imaging studies
Blockage of urine flow in an area below the kidneys results in postrenal azotemia. It can be caused by congenital abnormalities such as vesicoureteral reflux, blockage of the ureters by kidney stones, pregnancy, compression of the ureters by cancer, prostatic hyperplasia, or blockage of the urethra by kidney or bladder stones. Like in prerenal azotemia, there is no inherent renal disease. The increased resistance to urine flow can cause back up into the kidneys, leading to hydronephrosis. The BUN:Cr in postrenal azotemia is initially >15. The increased nephron tubular pressure (due to fluid back-up) causes increased reabsorption of urea, elevating it abnormally relative to creatinine.
Azotemia | Postrenal azotemia
Most stones form by a combination of genetics and environmental factors. Risk factors include high urine calcium levels; obesity; certain foods; some medications; calcium supplements; hyperparathyroidism; gout and not drinking enough fluids. Stones form in the kidney when minerals in urine are at high concentration. The diagnosis is usually based on symptoms, urine testing, and medical imaging. Blood tests may also be useful. Stones are typically classified by their location: nephrolithiasis (in the kidney), ureterolithiasis (in the ureter), cystolithiasis (in the bladder), or by what they are made of (calcium oxalate, uric acid, struvite, cystine). In those who have had stones, prevention is by drinking fluids such that more than two liters of urine are produced per day.
Kidney stone disease | Introduction
Kidney stones have been identified and recorded about as long as written historical records exist. The urinary tract including the ureters, as well as their function to drain urine from the kidneys, has been described by Galen in the second century AD. The first to examine the ureter through an internal approach, called ureteroscopy, rather than surgery was Hampton Young in 1929. This was improved on by VF Marshall who is the first published use of a flexible endoscope based on fiber optics, which occurred in 1964. The insertion of a drainage tube into the renal pelvis, bypassing the uterers and urinary tract, called nephrostomy], was first described in 1941.
Urinary system | History
A bladder stone is a stone found in the urinary bladder.
Bladder stone | Introduction
Stones less than in diameter pass spontaneously in up to 98% of cases, while those measuring in diameter pass spontaneously in less than 53% of cases. Stones that are large enough to fill out the renal calyces are called "staghorn stones", and are composed of struvite in a vast majority of cases, which forms only in the presence of urease-forming bacteria. Other forms that can possibly grow to become staghorn stones are those composed of cystine, calcium oxalate monohydrate, and uric acid.
Kidney stone disease | Size
The ureters are muscular ducts that propel urine from the kidneys to the urinary bladder. In the human adult, the ureters are usually 25–30 cm (10–12 in) long. In humans, the ureters arise from the renal pelvis on the medial aspect of each kidney before descending towards the bladder on the front of the psoas major muscle. The ureters cross the pelvic brim near the bifurcation of the iliac arteries (which they run over). This "pelviureteric junction" is a common site for the impaction of kidney stones (the other being the uteterovesical valve). The ureters run posteriorly on the lateral walls of the pelvis.
Excretory system | Ureter
There are a number of documented cases of historical figures and distinguished members of society who had kidney stones. This condition is caused by nephrolithiasis, which are more commonly known as kidney stones, or urolithiasis, where the stone forms in the urinary system. These are crystal deposits that can accrete in the urinary system when certain chemical substances become concentrated in the urine. Among the symptoms associated with nephrolithiasis are intense colicky pain, nausea, fever, chills, and the reduction or blockage of urine flow. Historically, the condition of having a kidney or bladder stone was referred to as "the stone" or "the gravel".
List of people with kidney stones | Introduction
With creation of a urinary diversion it is possible for the ureters to become obstructed preventing the drainage of urine from the kidneys. If this occurs, another procedure to insert a percuntaneous nephrostomy tube may be need to allow drainage of urine from the body. Obstruction of the ureter most commonly occurs at the site where the ureters are reconnected to the urinary diversion created. A small, hollow, flexible tube called a stent may be placed inside the ureter at the time of surgery to possibly help the reconnection site to heal. This reconnection site is also at risk for leaking urine within the abdomen.
Cystectomy | Urinary tract
If drainage is compromised for longer periods, the kidney can be damaged. Stents may also be placed in a ureter that has been irritated or scratched during a ureteroscopy procedure that involves the removal of a stone, sometimes referred to as a 'basket grab procedure'. Stents placed for this reason are normally left in place for about a week. These stents ensure that the ureter does not spasm and collapse after the trauma of the procedure.
Ureteric stent | Stent placement
This is for causes other than gall stones. At admission: Within 48 hours: For acute pancreatitis secondary to gall stones.
Ranson criteria | Usage
The line of stones is orientated north-east to south-west.
Ballochroy | Introduction
About 5–10% of all stones are formed from uric acid. People with certain metabolic abnormalities, including obesity, may produce uric acid stones. They also may form in association with conditions that cause hyperuricosuria (an excessive amount of uric acid in the urine) with or without hyperuricemia (an excessive amount of uric acid in the serum). They may also form in association with disorders of acid/base metabolism where the urine is excessively acidic (low pH), resulting in precipitation of uric acid crystals. A diagnosis of uric acid urolithiasis is supported by the presence of a radiolucent stone in the face of persistent urine acidity, in conjunction with the finding of uric acid crystals in fresh urine samples.
Kidney stone disease | Uric acid stones
The diagnosis of renal colic is same as the diagnosis for the renal calculus and ureteric stones.
Renal colic | Diagnosis
Dehydration from low fluid intake is a major factor in stone formation. Individuals living in warm climates are at higher risk due to increased fluid loss. Obesity, immobility, and sedentary lifestyles are other leading risk factors. High dietary intake of animal protein, sodium, sugars including honey, refined sugars, fructose and high fructose corn syrup, and excessive consumption of tea or fruit juices may increase the risk of kidney stone formation due to increased uric acid excretion and elevated urinary oxalate levels. Kidney stones can result from an underlying metabolic condition, such as distal renal tubular acidosis, Dent's disease, hyperparathyroidism, primary hyperoxaluria, or medullary sponge kidney.
Kidney stone disease | Risk factors
Ureteral development begins in the human fetus around the 4th week of embryonic development. A ureteric bud, arising from the mesonephric (or Wolffian) duct, gives rise to the ureter, as well as other parts of the collective system. In the case of a duplicated ureter, the ureteric bud either splits or arises twice. In most cases, the kidney is divided into two parts, an upper and lower lobe, with some overlap due to intermingling of collecting tubules. However, in some cases the division is so complete as to give rise to two separate parts, each with its own renal pelvis and ureter.
Duplicated ureter | Pathophysiology
Most stones under pass spontaneously. Prompt surgery may, nonetheless, be required in persons with only one working kidney, bilateral obstructing stones, a urinary tract infection and thus, it is presumed, an infected kidney, or intractable pain. Beginning in the mid-1980s, less invasive treatments such as extracorporeal shock wave lithotripsy, ureteroscopy, and percutaneous nephrolithotomy began to replace open surgery as the modalities of choice for the surgical management of urolithiasis. More recently, flexible ureteroscopy has been adapted to facilitate retrograde nephrostomy creation for percutaneous nephrolithotomy. This approach is still under investigation, though early results are favorable. Percutaneous nephrolithotomy or, rarely, anatrophic nephrolithotomy, is the treatment of choice for large or complicated stones (such as calyceal staghorn calculi) or stones that cannot be extracted using less invasive procedures.
Kidney stone disease | Surgery
The urine will appear thick and creamy or sometimes sandy. Small stones and sand can be removed using urohydropropulsion. Prevention is through reducing calcium intake by feeding more hay and less commercial rabbit pellets, and by not using mineral supplements.
Bladder stone (animal) | Calcium oxalate stones
The hallmark of a stone that obstructs the ureter or renal pelvis is excruciating, intermittent pain that radiates from the flank to the groin or to the inner thigh. This pain, known as renal colic, is often described as one of the strongest pain sensations known. Renal colic caused by kidney stones is commonly accompanied by urinary urgency, restlessness, hematuria, sweating, nausea, and vomiting. It typically comes in waves lasting 20 to 60 minutes caused by peristaltic contractions of the ureter as it attempts to expel the stone. The embryological link between the urinary tract, the genital system, and the gastrointestinal tract is the basis of the radiation of pain to the gonads, as well as the nausea and vomiting that are also common in urolithiasis.
Kidney stone disease | Signs and symptoms
In 1842, Bird became the first to describe oxaluria, sometimes called Bird's disease, which is sometimes caused by an excess of oxalate of lime in the urine. This is the most common type of kidney stone. The most common cause of kidney stones is now known to be an excess of calcium in the urine, not oxalate, though Calcium oxalate stones are the most common type, it is the excess of calcium that is the most common cause of their formation. Some people do however have an excess of oxalate in their urine and form Calcium oxalate stones because of that; this can be related to diet, hereditary factors or intestinal diseases.
Golding Bird | Urology
Bartholomew's. In 1790 he delivered the Goulstonian Lectures at the College of Physicians, of which he had been elected a fellow in 1787. The lectures were on the stone, and were published in 1791. The Gulstonian Lectures are printed as "A Treatise on the Origin and Component Parts of the Stone in the Urinary Bladder" (London, 1791). This work contains a series of experiments made according to the defective chemistry of their time and of no permanent value. Their erroneous result is "that the stone is formed generally in very small part, and often in no degree whatever, from the urine as secreted by the kidneys, but chiefly from the mucus produced from the sides of the different cavities through which the urine passes"; and this led the author to a melancholy conclusion as to a common form of the affection: The imperfect chemistry of his time was sufficient to lead Austin to one accurate conclusion, the variety of composition of hard concretions found throughout the body; and he also points out correctly that the hard matter found in the arteries of old people is calcareous, while the white substance covering the surface of gouty joints is not so.
William Austin (physician) | Career
Prenatally diagnosed hydronephrosis (fluid-filled kidneys) suggest post-natal follow-up examination. The strongest neo-natal presentation is urinary tract infection. A hydronephrotic kidney may present as a palpable abdominal mass in the newborn, and may suggest an ectopic ureter or ureterocele. In older children, ureteral duplication may present as:
Duplicated ureter | Diagnosis
1.3% of condom catheter users will develop a bladder or renal stone requiring medical treatment. While the line of causation is not well established, urinary retention from inefficient elimination while catheterized may allow more mineral buildup and encourage crystal growth.
Urine collection device | Managing incontinence
Jackstone calculi are rare bladder stones that have an appearance resembling toy jacks. They are almost always composed of calcium oxalate dihydrate and consist of a dense central core and radiating spicules. They are typically light brown with dark patches and are usually formed in the urinary bladder and rarely in the upper urinary tract. Their appearance on plain radiographs and computed tomography in human patients is usually easily recognizable. Jackstones often must be removed via cystolithotomy.
Bladder stone | Jackstone calculus
The ureters are richly supplied by nerves that form a network () of nerves, the ureteric plexus that lies in the adventitia of the ureters. This plexus is formed from a number of nerve roots directly (T9-12, L1, and S2-4), as well as branches from other nerve plexuses and nerves; specifically, the upper third of the ureter receives nerve branches from the renal plexus and aortic plexus, the middle part receives branches from the upper hypogastric plexus and nerve, and the lower ureter receives branches from the lower hypogastric plexus and nerve. The plexus is in the adventitia. The these nerves travel in individual bundles and along small blood vessels to form the ureteric plexus.
Ureter | Nerve supply
Fictional incidents of kidney stones have been portrayed in the media on several occasions.
List of people with kidney stones | Fictional
The position these holes precisely repeats the structure of the whole stone ring, each hole corresponds to a menhir of the ring.
Megaliths in the Urals | Menhirs
A ureteric stent may be inserted to relieve an obstruction. If the cause cannot be removed, a nephrostomy may be required, which is the insertion of a tube connected to the renal pelvis which directly drains urine into a stoma bag.
Ureter | Anatomical and surgical abnormalities
A urologist inserts a scope into the urinary tract to locate the stone. The scope may be a cystoscope, ureteroscope, renoscope or nephroscope. An optical fiber is inserted through the working channel of the scope, and laser light is directly emitted to the stone. The stone is fragmented and the remaining pieces are collected in a "basket" and/or washed out of the urinary tract, along with the finer particulate "dust." The procedure is done under either local or general anesthesia and is considered a minimally-invasive procedure. It is widely available in most hospitals in the world.
Laser lithotripsy | Procedure
IVU-shows Adder head appearance or Cobra head appearance. Cystoscopy-shows translucent cyst which is thin walled surrounding ureteric orifice
Ureterocele | Diagnosis
The ureter is lined by urothelium, a type of transitional epithelium that is capable of responding to stretches in the ureters. The transitional epithelium may appear as a layer of column-shaped cells when relaxed, and of flatter cells when distended. Below the epithelium sits the lamina propria. The lamina propria is made up of loose connective tissue with many elastic fibers interspersed with blood vessels, veins and lymphatics. The ureter is surrounded by two muscular layers, an inner longitudinal layer of muscle, and an outer circular or spiral layer of muscle. The lower third of the ureter has a third muscular layer.
Ureter | Microanatomy
More definitive ureteroscopic techniques for stone extraction (rather than simply bypassing the obstruction) include basket extraction and ultrasound ureterolithotripsy. Laser lithotripsy is another technique, which involves the use of a holmium:yttrium aluminium garnet (Ho:YAG) laser to fragment stones in the bladder, ureters, and kidneys. Ureteroscopic techniques are generally more effective than ESWL for treating stones located in the lower ureter, with success rates of 93–100% using Ho:YAG laser lithotripsy. Although ESWL has been traditionally preferred by many practitioners for treating stones located in the upper ureter, more recent experience suggests ureteroscopic techniques offer distinct advantages in the treatment of upper ureteral stones.
Kidney stone disease | Ureteroscopic surgery
This indicates that the stones were intentionally removed and didn't fall off the structures over time due to natural processes.
Actuncan site | E-Group and Structure 19A
The term "renal calculus" is from the Latin "rēnēs", meaning "kidneys", and "calculus", meaning "pebble". Lithiasis (stone formation) in the kidneys is called nephrolithiasis (), from "nephro-", meaning kidney, + "-lith", meaning stone, and "-iasis", meaning disorder. A distinction between nephrolithiasis and urolithiasis can be made because not all urinary stones (uroliths) form in the kidney; they can also form in the bladder. But the distinction is often clinically irrelevant (with similar disease process and treatment either way) and the words are thus often used loosely as synonyms.
Kidney stone disease | Etymology
However, some patients have an infected stone and are simply too ill for an operative surgical removal. In these instances, the mainstay of IR treatment is a percutaneous nephrostomy tube. This is a procedure where a small caliber catheter is placed through the skin and into the urinary collecting system upstream of the stone. This procedure not only drains any infection, often bringing about a precipitous improvement in the patient's symptoms but also diverts urine—thus giving the patient more time to recover before definitive surgical treatment.
Interventional radiology | Kidney stone disease
Other theories suggest that dilatation of a collecting duct may occur, caused by occlusion by uric acid during fetal life or resulting from tubular obstruction due to calcium oxalate calculi secondary to infantile hypercalciuria. A rare, autosomal recessive form is associated with Caroli disease.
Medullary sponge kidney | Cause
If the ureters have been resited as a result of surgery, for example due to a kidney transplant or due to past surgery for vesicuureteric reflux, that site may also become narrowed. A narrowed ureter may lead to ureteric enlargement () and cause swelling of the kidneys (hydronephrosis). Associated symptoms may include recurrent infections, pain or blood in the urine; and when tested, kidney function might be seen to decrease. These are considered situations when surgery is needed. Medical imaging, including urinary tract ultrasound, CT or nuclear medicine imaging is conducted to investigate many causes. This may involve reinserting the ureters into a new place on the bladder (reimplantion), or widening of the ureter.
Ureter | Anatomical and surgical abnormalities
Scientifically, masses referred to as a renal calculus or nephrolith, or more commonly, “kidney stones,” are solid masses of crystals that may be a variety of shapes, sizes, and textures, that can reside within one or both of the kidneys. Kidney stones form when the balance is off between the concentration of substances that pass through urine, and the substances that are supposed to dissolve them. When substances are not properly dissolved, they have the ability to build up, and form these kidney stones. These stones are most commonly made up of substances such as calcium, cystine, oxalate, and uric acid, as these are the substances that normally would dissolve within the urine.
Excretory system | Kidney Stones
People with certain rare inborn errors of metabolism have a propensity to accumulate crystal-forming substances in their urine. For example, those with cystinuria, cystinosis, and Fanconi syndrome may form stones composed of cystine. Cystine stone formation can be treated with urine alkalinization and dietary protein restriction. People afflicted with xanthinuria often produce stones composed of xanthine. People afflicted with adenine phosphoribosyltransferase deficiency may produce 2,8-dihydroxyadenine stones, alkaptonurics produce homogentisic acid stones, and iminoglycinurics produce stones of glycine, proline, and hydroxyproline. Urolithiasis has also been noted to occur in the setting of therapeutic drug use, with crystals of drug forming within the renal tract in some people currently being treated with agents such as indinavir, sulfadiazine, and triamterene.
Kidney stone disease | Other types
The Integrated Medical Model (IMM) group at Glenn Research Center in Ohio has been analyzing and optimizing data gathered on renal stone formation since late 2008.
Renal stone formation in space | Computer based simulations
Ureteroscopy is an examination of the upper urinary tract, usually performed with a ureteroscope that is passed through the urethra and the bladder, and then directly into the ureter. The procedure is useful in the diagnosis and treatment of disorders such as kidney stones and urothelial carcinoma of the upper urinary tract. Smaller stones in the bladder or lower ureter can be removed in one piece, while bigger ones are usually broken before removal during ureteroscopy. The examination may be performed with either a flexible, semi-rigid or rigid device while the patient is under anesthesia. In specific cases, the patient is free to go home after the examination.
Ureteroscopy | Introduction
From one stone a slab runs south and could be part of a tomb chamber or cist set in an oval cairn 1m high.
Eightercua | Introduction
Increasing fluid intake can facilitate the passage of small bladder stones. However, larger stones may require other methods of treatment. Fragmentation of bladder stones can be achieved by use of a cystoscope which is inserted into the bladder. The urologist visualizes the stone and uses ultrasonic energy or laser lithotripsy to cause fragmentation of the stones into small pieces, which are then flushed out of the bladder. This procedure requires anesthesia and may require admission to a hospital. Complications of this treatment include infection and damage to the bladder. Some stones are too large even for cystoscopic treatment and may require open cystotomy, in which an incision is made in the bladder and the stones are removed manually.
Bladder stone | Management
The duct of the mesonephros forms the Wolffian duct and ureter of the adult kidney. The embryonic kidney and its derivatives also produces the inductive signals that trigger formation of the adult kidney.
Pronephros | Introduction
Stones can cause disease by several mechanisms: A number of important medical conditions are caused by stones:
Calculus (medicine) | Pathophysiology and symptoms
A calculus (plural calculi), often called a stone, is a concretion of material, usually mineral salts, that forms in an organ or duct of the body. Formation of calculi is known as lithiasis (). Stones can cause a number of medical conditions. Some common principles (below) apply to stones at any location, but for specifics see the particular stone type in question. Calculi are not to be confused with gastroliths.
Calculus (medicine) | Introduction
Stones lodged in the urethra can often be flushed into the bladder and removed, but sometimes a urethrotomy is necessary. In male dogs with recurrent urinary tract obstruction a scrotal urethrostomy creates a permanent opening in the urethra proximal to the area where most stones lodge, behind the os penis. In male cats, stones lodge where the urethra narrows in the penis. Recurrent cases can be treated surgically with a perineal urethrostomy, which removes the penis and creates a new opening for the urethra. To prevent recurrence of stones, special diets can be used for each type of stone. Increasing water consumption by the animal dilutes the urine, which prevents oversaturation of the urine with crystals.
Bladder stone (animal) | Treatment
Over time, as the bladder enlarges, it absorbs the surrounding parts of the primitive ureters. Finally, the entry points of the ureters into the bladder move upwards, owing to the upward migration of the kidneys in the developing embryo.
Ureter | Development
The use of medications to speed the spontaneous passage of stones in the ureter is referred to as medical expulsive therapy. Several agents, including alpha adrenergic blockers (such as tamsulosin) and calcium channel blockers (such as nifedipine), may be effective. Alpha-blockers likely result in more people passing their stones, and they may pass their stones in a shorter time. Alpha-blockers appear to be more effective for larger stones (over 5 mm in size) than smaller stones. A combination of tamsulosin and a corticosteroid may be better than tamsulosin alone. These treatments also appear to be a useful in addition to lithotripsy.
Kidney stone disease | Medical expulsive therapy
The Indeterminacy Stones, begun in 1994, consisted of a chunk of pyrite, set atop a piece of marble, and then left outdoors to weather. The pyrite transformed into limonite when exposed to the elements, leaving a permanent iron rust stain. It may take less than ten years or over a century to dissolve depending on composition and environment. For the first exhibition of these works at Sandra Gering Gallery, New York, 1995, three boulders were gathered—one flat, one vertical, one wedge-shaped. Ann Barclay Morgan, writing about work in Sculpture Magazine, commented “…the action of “bleeding”…could be seen as the female life-force in the process of being released.
Dove Bradshaw | "Indeterminacy" (1995)
Pyonephrosis is sometimes a complication of kidney stones, which can be a source of persisting infection. It may also occur spontaneously. It can occur as a complication of hydronephrosis or pyelonephritis.
Pyonephrosis | Causes
Hypocitraturia or low urinary-citrate excretion (defined as less than 320 mg/day) can cause kidney stones in up to 2/3 of cases. The protective role of citrate is linked to several mechanisms; citrate reduces urinary supersaturation of calcium salts by forming soluble complexes with calcium ions and by inhibiting crystal growth and aggregation. Therapy with potassium citrate or magnesium potassium citrate is commonly prescribed in clinical practice to increase urinary citrate and to reduce stone formation rates.
Kidney stone disease | Hypocitraturia
Bladder stones or uroliths are a common occurrence in animals, especially in domestic animals such as dogs and cats. Occurrence in other species, including tortoises, has been reported as well. The stones form in the urinary bladder in varying size and numbers secondary to infection, dietary influences, and genetics. Stones can form in any part of the urinary tract in dogs and cats, but unlike in humans, stones of the kidney are less common and do not often cause significant disease, although they can contribute to pyelonephritis and chronic kidney disease. Types of stones include struvite, calcium oxalate, urate, cystine, calcium phosphate, and silicate.
Bladder stone (animal) | Introduction
Signals released from the ureteric bud induce the differentiation of the metanephrogenic blastema into the renal tubules. As the renal tubules grow, they come into contact and join with connecting tubules of the collecting duct system, forming a continuous passage for flow from the renal tubule to the collecting duct. Simultaneously, precursors of vascular endothelial cells begin to take their position at the tips of the renal tubules. These cells differentiate into the cells of the definitive glomerulus. In humans, all of the branches of the ureteric bud and the nephronic units have been formed by 32 to 36 weeks of gestation.
Kidney development | Metanephros
Ureteral cancer is cancer of the ureters, muscular tubes that propel urine from the kidneys to the urinary bladder. It is also known as ureter cancer, renal pelvic cancer, and rarely ureteric cancer or uretal cancer. Cancer in this location is rare. Ureteral cancer is usually transitional cell carcinoma. Transitional cell carcinoma is "a common cause of ureter cancer and other urinary (renal pelvic) tract cancers."
Ureteral cancer | Introduction
A significant quantity of rounded stones are still present and some are exposed to view in situ or spread around the site. A few larger boulders, possibly perimeter stones are present and the indications are that the diameter of the cairn may originally have been over 20m. The stones are whinstone and mostly large. No hammer or chisel marks were found on any of the stones. The three urns found were buried in pits that were close to the original ground level. One urn was around a foot in diameter and the other two were 5½ inches in diameter and six inches in height, with zig-zag lines around the rim.
Cairnduff | Description
They are also commonly seen in people with underlying metabolic disorders, such as idiopathic hypercalciuria, hyperparathyroidism, and gout. Infection stones can grow rapidly, forming large calyceal staghorn (antler-shaped) calculi requiring invasive surgery such as percutaneous nephrolithotomy for definitive treatment. Struvite stones (triple-phosphate/magnesium ammonium phosphate) have a 'coffin lid' morphology by microscopy.
Kidney stone disease | Struvite stones
Bladder stones may cause blood in the urine (hematuria) (giving the appearance that the animal is urinating blood) but sometimes there may be no signs at all. Painful urination or straining to urinate are other signs. Urinary tract infections are commonly associated with bladder stones. Smaller stones may become lodged in the urethra, especially in male animals, causing urinary tract obstruction and the inability to urinate. This condition causes acute kidney failure, hyperkalemia, sepsis, and death within a few days.
Bladder stone (animal) | Signs and symptoms
The ureters develop from the ureteric buds, which are outpouchings from the mesonephric duct. This is a duct, derived from mesoderm, found in the early embryo. Over time, the buds elongate, moving into surrounding mesodermal tissue, dilate, and divide into left and right ureters. Eventually, successive divisions from these buds form not only the ureters, but also the pelvis, major and minor calyces, and collecting ducts of the kidneys. The mesonephric duct is connected with the cloaca, which over the course of development splits into a urogenital sinus and the anorectal canal. The urinary bladder forms from the urogenital sinus.
Ureter | Development
Cystinuria is a cause of persistent kidney stones. It is a disease involving the defective transepithelial transport of cystine and dibasic amino acids in the kidney and intestine, and is one of many causes of kidney stones. If not treated properly, the disease could cause serious damage to the kidneys and surrounding organs, and in some rare cases death. The stones may be identified by a positive nitroprusside cyanide test. The crystals are usually hexagonal, translucent, white. Upon removal, the stones may be pink or yellow in color, but later they turn to greenish due to exposure to air. Cystinuria is usually asymptomatic when no stone is formed.
Cystinuria | Presentation
The diagnosis of bladder stone includes urinalysis, ultrasonography, x rays or cystoscopy (inserting a small thin camera into the urethra and viewing the bladder). The intravenous pyelogram can also be used to assess the presence of kidney stones. This test involves injecting a radiocontrast agent which is passed into the urinary system. X-ray images are then obtained every few minutes to determine if there is any obstruction to the contrast as it is excreted into the bladder. Today, intravenous pyelogram has been replaced at many health centers by CT scans. CT scans are more sensitive and can identify very small stones not seen by other tests.
Bladder stone | Diagnosis
Diagnosis of kidney stones is made on the basis of information obtained from the history, physical examination, urinalysis, and radiographic studies. Clinical diagnosis is usually made on the basis of the location and severity of the pain, which is typically colicky in nature (comes and goes in spasmodic waves). Pain in the back occurs when calculi produce an obstruction in the kidney. Physical examination may reveal fever and tenderness at the costovertebral angle on the affected side.
Kidney stone disease | Diagnosis
Urology addresses diseases of kidney (and urinary tract) "anatomy": these include cancer, renal cysts, kidney stones and ureteral stones, and urinary tract obstruction.
Kidney | Introduction
Repeat stone formers benefit from more intense management, including proper fluid intake and use of certain medications, as well as careful monitoring.
Kidney stone disease | Treatment
Preventative measures depend on the type of stones. In those with calcium stones, drinking plenty of fluids, thiazide diuretics and citrate are effective as is allopurinol in those with high uric acid levels in the blood or urine.
Kidney stone disease | Prevention
Urate (CHNO) stones, usually ammonium urate (NH·CHNO) or sodium urate monohydrate (Na·CHNO×HO), form in an acidic to neutral urine. They are usually small, yellow-brown, smooth stones. Urate stones form due to an increased excretion of uric acid in the urine. Dalmatians (especially males) and to a lesser extent Bulldogs are genetically predisposed to the formation of urate stones because of an altered metabolism of purines. Dalmatians have a decreased rate of urate hepatic transport, leading to only about 30 to 40 percent conversion of urate to allantoin, compared with greater than 90 percent conversion in other breeds. Dogs with portosystemic shunts or endstage liver disease also have increased uric acid excretion in the urine due to reduced conversion of uric acid to allantoin and ammonia to urea.
Bladder stone (animal) | Urate stones