Kidney stone disease has been on the rise in recent decades, affecting both men and women of various ages. Sedentary lifestyle, obesity, and a diet rich in ultra-processed foods and sodium are major contributors to this scenario. Recurrence is common, and without proper guidance, many patients experience multiple episodes throughout life.
Symptoms and First Signs
Kidney stones may remain asymptomatic or present with sudden and intense pain, often described as one of the strongest pains a person can experience. Pain usually starts in the lower back or side and may radiate to the groin. Nausea, vomiting, urinary urgency, and blood in the urine are common accompanying symptoms.
Diagnosis: Imaging Is Essential
The gold standard for diagnosis is non-contrast-enhanced computed tomography, which allows precise localization and measurement of the stone. In simpler cases, ultrasound or plain abdominal radiography may be used. Urinalysis and kidney function tests are important for assessing complications.
When Is Surgery Needed?
Not all kidney stones require surgical intervention. Stones under 5 mm often pass spontaneously with hydration and analgesia. However, larger stones, those causing infection, significant obstruction, or persistent pain despite clinical measures may require endoscopic removal or laser lithotripsy. For ureteral stones, location and size guide the urgency and technique used.
Urgent Indications for Intervention:
- Fever or suspected infection associated with obstruction
- Severe or persistent pain
- Deterioration of kidney function
- Single functioning kidney with obstruction
Metabolic Evaluation and Stone Analysis
After acute treatment, a full metabolic evaluation is essential to prevent recurrence. Tests include 24-hour urine collection to assess calcium, citrate, oxalate, uric acid, and volume. The chemical composition of the stone, analyzed by crystallography or infrared spectroscopy, offers valuable information for targeted prevention.
Prevention: The Key to Success
General measures include:
- Drinking at least 2.5 liters of water a day
- Reducing sodium intake
- Limiting excessive consumption of animal protein
- Increasing intake of fruits, vegetables, and citrate-rich foods (like lemon)
Urology with Precision and Follow-up
Modern urology allows safe and effective treatment of kidney stones with minimally invasive techniques. The most important factor, however, is long-term follow-up and individualization of prevention strategies.
**Insights by Dr. Pedro Bastos - Urologista em Juiz de Fora**
https://drpedrobastosurologista.com.br
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