[Health Tip] 'As Painful as Childbirth?'... How to Prevent Urolithiasis

Urinary Stone Image

[Asia Economy Reporter Chunhee Lee] The greatest pain is often said to be childbirth pain. However, among the 'three major causes of pain' recognized in the medical field, alongside childbirth and acute pulpitis, is urinary tract stones. Urinary tract stones, if left untreated, can cause pyelonephritis or sepsis and may lead to kidney damage requiring dialysis, which is why they are sometimes called the 'silent assassin.'

Since it is known that 1 in 10 people in Korea may have urinary tract stones at least once in their lifetime, it is important to get tested and treated promptly if symptoms of urinary tract stones are suspected. Professor Seongyong Cho of the Department of Urology at Seoul National University Hospital emphasized, "Basically, drinking plenty of water helps stones to be expelled through urine," and added, "Controlling the intake of foods high in substances that form stones is a preventive measure against urinary tract stones." On the other hand, regarding the popular belief about beer, he pointed out, "Beer contains a large amount of substances that form stones," and warned, "Drinking beer actually increases the likelihood of stone formation." We also looked into the causes, symptoms, examinations, and treatments of urinary tract stones.

- What are urinary tract stones?

▲The urinary tract refers to the path through which urine flows from the kidneys, through the ureters, bladder, and urethra. When crystals such as mineral salts in the urine become saturated and clump together in the urinary tract, they form masses that block the urine flow or cause inflammation; these are called urinary tract stones.

- What causes them?

▲Decreased water intake is the most important cause of urinary tract stones. When water intake decreases, the crystals that form stones remain longer in the urine, increasing the rate of stone formation. The prevalence of stones is about 11-13%, with men having a higher risk than women. Temperature and season are also important factors in the occurrence of urinary tract stones. In summer, excessive sweating concentrates the urine, increasing the possibility of stone formation.

- What are the symptoms?

▲Urinary tract stones can cause severe pain as various shaped stone crystals scratch and injure the urinary tract while passing with urine. The pain is so severe it is compared to labor pain and is also called 'renal colic.' The pain can last more than 10 hours. Additionally, when stones block the urinary tract during passage, the kidney may swell, causing nausea or vomiting. However, some people may have no symptoms. Even with stones, if the urinary tract is not completely blocked, there may be no pain, or if the blockage has been long-standing causing kidney function damage, pain may not even be felt.

- Do they recur?

▲Urinary tract stones often recur, with about 7% recurring within one year and about 50% within five years after the first occurrence. Even after procedures like shock wave therapy, if some broken stone fragments remain, the recurrence rate increases, and stones are likely to form again in the same location.

- How can they be prevented?

▲Drinking plenty of water is very important as it helps stones to be expelled through urine. Also, controlling the intake of foods high in stone-forming substances should not be forgotten.

If stones settle in the lower part of the kidney, adopting the prone stretch (down dog) position or lowering the head using a bed, sofa, or exercise equipment can help induce stone expulsion. Frequently tapping the back (kidney area) to help stones move is also beneficial.

- What are the treatments?

▲If the stones are small, they may be naturally expelled. However, if the size is 5 mm or larger, the natural expulsion rate decreases. For stones of medium size, about 5 to 15 mm, extracorporeal shock wave lithotripsy (ESWL) is performed, which focuses shock waves on the stones to break them down. If stones do not break after ESWL or if the stones are large, ureteroscopic stone removal is performed by inserting a flexible endoscope into the urethra and removing the stones with a laser. This procedure is done under general anesthesia without skin incisions, and most patients can resume normal activities within 1-2 days after surgery.

For very large stones, 15 to 20 mm or more, percutaneous nephrolithotomy (PCNL) is performed by creating a passage through the side to insert an endoscope into the kidney to remove or laser-break the stones. This method is also done under general anesthesia, has a quick recovery period without large incisions, but carries a risk of significant bleeding.

- Does drinking beer help prevent urinary tract stones?

▲If the stones lodged in the urinary tract are small, the chance of natural expulsion within a month is only about 5-60%. While drinking beer might help push stones out by increasing urine pressure, beer contains a large amount of substances like oxalate that form stones. Therefore, drinking a lot of beer regularly actually increases the likelihood of stone formation.

- Does coffee consumption cause urinary tract stones?

▲Coffee with a lot of sugar is obviously bad for stones. However, there is no established information yet on how coffee itself affects urinary tract stones.

- If you have prostatitis, do you also get urinary tract stones?

▲The prostate surrounds the urinary tract. Urine entering the prostate can cause inflammation, leading to calcification or stones inside the prostate, but this is different from urinary tract stones. Prostatitis and urinary tract stones are fundamentally different diseases.

Professor Seongyong Cho, Department of Urology, Seoul National University Hospital

This content was produced with the assistance of AI translation services.