Bladder calculations are accumulation of hard minerals that form in the urinary bladder.
Causes: Bladder calculations are usually the result of another urological problem, such as:
Urinary tract infections.
Approximately 95% of all bladder calculations occur in men but are much less common in kidney stones. Bladder calculations can occur when urine in the bladder is concentrated and the materials crystallize. Symptoms occur when the calculation is irritating to the bladder coating or hampers the flow of urine from the bladder.
SYMPTOMS: The most common are:
Abnormal color of the urine;
Blood in the urine;
Difficulty in urinating;
Frequent Urinal Stimulation;
Inability to urinate, except in certain positions;
Urinary flow interruption;
Pain or discomfort to the penis;
Urinary tract infections (Disorientation or painful or urgent urination);
Incontinence may also be associated with bladder calculations.
DIAGNOSIS: Your doctor will do the following:
Rages-X to the bladder or basin;
Physical examination, including rectal examination;
Urine analysis to show blood in urine or an infection;
THERAPY: Drinking 6-8 glasses of water or more per day to increase urinary output can help pass the calculations. The doctor can remove the calculations that do not pass by themselves using a cystoscope (a small tube that passes through the urethra to the bladder). The shock waves extracorporeal lithotripsy uses ultrasonic waves to break the calculations. Some calculations can be removed with the surgery.
Drugs are rarely used to melt the calculations. The causes that led to bladder calculations have to be cured. More commonly, bladder calculus is detected in conjunction with benign prostatic hyperplasia or bladder obstruction. For patients with this condition, transurethral prostate resection can be performed.
PROBLEMS: Most bladder calculations are expelled or can be removed without permanent damage to the bladder. They can go back if the cause is not cared for. If not treated, calculations can cause repeated urinary tract infections or permanent damage to the bladder or kidneys. Possible complications may be:
Acute obstructive bilirubin syndrome;
Chronic bladder dysfunction (incontinence or urinary retention);
Return of calculations;
Urinary tract infections.
Contact a doctor if the symptoms are bladder calculations appear.
PREVENTION: Early treatment of urinary tract infections or other urologic disorders can help prevent bladder calculations.
Sources: [Segura JW. Lower Urinary Calculation. In: Wein AJ. Wein: Campbell-Walsh Urology. 9th ed. Philadelphia, PA: Saunders Elsevier, 2007; http://health.nytimes.com/health/]
Gallbladder calculations (gallbladder calculations)
Gallstones, or gallbladder calculations, are hard deposits that form inside the gallbladder. They can be as small as a grain of sand or big as a golf ball.
Causes: The cause of biliary calculations varies. There are two main types of gallstones
Cholesterol calculations, which are by far the most common type. They have nothing to do with cholesterol levels in the blood;
Bilirubin calculations, which can occur when red blood cells are destroyed (hemolysis). This leads to too much bilirubin in the bile. Pigmented calculations are also known.
Gallstones are more common in women, Native Americans, Hispanics, and people over the age of 40, and may be hereditary. The risk factors for developing gallstones are:
Bone marrow transplantation or other solid organs;
Gallbladder failure that no longer emits bile (this is most likely to occur during pregnancy);
Hepatic cirrhosis and gallbladder infections (pigmented calculations);
Medical conditions that cause too much bilirubin production, such as chronic hemolytic anemia and sickle cell anemia;
Fast weight loss due to very few calories, or after bariatric surgery;
Receive nourishment for endovine for a long time.
SYMPTOMS: Many people with biliary stones have no symptoms. Gallstones are often found during an x-ray examination for other reasons, abdominal surgery, or other medical procedures. However, if the large blocks interrupt the cystic duct or common bile duct (called coledocolitiasis), there may be cramps in the center and right of the upper abdomen. This is known as biliary colic. The pain goes away if the calculation passes in the first part of the small intestine (the duodenum). The symptoms that may occur are:
Pain in the middle upper right part of the upper abdomen that may be constant, sharp, and may spread to the back or under the right shoulder;
Clay colored clay;
Nausea and vomit.
It is important to consult a physician if you have the symptoms of biliary calculations.
DIAGNOSIS: The analyzes used to detect gallstones or inflammation of gallbladder are
Endoscopic retrograde colangiopancreatography;
Radionuclide gallbladder scan;
Magnetic Resonance Colangiopancreatography;
Percutaneous transepathy colangiophage;
Liver function tests;
THERAPY: Surgery is not usually necessary unless symptoms occur. The only exception is in patients who have undergone surgery for weight loss. In general, patients who have symptoms will undergo surgery or immediately, or after a short period of time.
A technique called laparoscopic cholecystectomy is most commonly used today. This procedure uses small surgical cuts that allow faster recovery. Patients are often resigned on the day of surgery, or the next morning. In the past, open cholecystectomy (gall bladder removal) was the normal procedure for uncomplicated cases. However, this is less often done now. Endoscopic retrograde cholangiopancreatography and a procedure called sfinterotomy may be performed to find or treat the calculus in the common bile duct.
Drugs called chenodeoxycholic acid or ursodesoxic acid (ursodiol) acids can be administered in the form of a pill to dissolve gallstones of cholesterol. However, they may need to be taken for 2 years or more before they have results and calculations may return after the end of treatment.
Rarely, chemicals are passed through the gallbladder through a catheter. The chemical quickly dissolves the calculations. This treatment is not used very often because it is difficult to perform, chemicals can be toxic, and biliary calculus may return.
Electro-hydraulic gallstones of gall bladder lithotrips have also been used for some patients who may not have surgery. Because gallstones often return to many patients, this treatment is not used much.
PROBLEMS: Gallstones in many people develop without causing any symptoms. The likelihood of symptoms or complications from biliary calculations is low. Almost all patients who have undergone gallbladder surgery do not have symptoms returning. Possible complications may be:
Contact a doctor if:
Pain in the upper abdomen;
Yellowing of skin or white eyes.
PREVENTION: In most people, biliary calculations can not be avoided. In obese people, avoiding rapid weight loss could prevent gallstones.
[Source: Ny Times]
A kidney calculus is a solid mass made of tiny crystals. One or more calculations can be in the kidneys or urethra at the same time.
Causes: kidney stones may form when urine contains excessive amounts of certain substances. These substances can create small crystals that become calculations. The major risk factor for kidney stones is dehydration. Calculations can not produce the symptoms until they begin to move down into the urethra. When this happens, they can block urine flow in the kidneys. This causes swelling of the kidneys (or even one), causing pain, usually severe. Renal calculations are common. A person who has had kidney stones often finds them going back several times in life. They often occur in premature children. Some types tend to be hereditary, others may develop with an intestinal disorder, an obstructive by-pass for obesity, or kidney failure. There are several types of kidney stones. The exact cause depends on the type:
Calcium calcium is the most common. They occur more often in men, and usually appear between 20 and 30 years. They risk coming back even if they are cared for. Calcium can be combined with other substances, such as oxalate (the most common substance), phosphate, or carbonate. The oxalate is present in some foods. Small intestine diseases increase the risk of calcium saliva calculations;
Cystine calculations can be formed in people with cystinuria. This disorder is hereditary and affects both men and women;
Most of the struvite calculations appear in women who have urinary tract infections. These can grow a lot until blocking the kidney, urethra or bladder;
Uric acid calculations are more common in humans and may occur with chemotherapy or gout.
Other substances may form other types of minor calculations.
SYMPTOMS: The main symptom is a severe pain that begins suddenly and can go as suddenly as possible:
Pain can be felt in the belly or on one side of the back;
Pain can move in the groin or in the testis.
Other symptoms may include:
Abnormal color of urine;
Blood in the urine;
DIAGNOSIS: Pain can be strong enough to require painkillers. The belly (abdomen) or kidney area may feel tired. Examinations for kidney stones include:
Calculation analysis to show what type it is;
Uric acid level;
Urine analysis to see crystals and red blood cells in the urine.
Calculation or block of urethra can be seen with:
Abdominal computerized tomography;
Abdominal and kidney magnetic resonance imaging;
Ultrasound to the kidneys;
Exams can show high levels of calcium, oxylate, or uric acid in the blood or urine.
THERAPY: The purpose of the treatment is to relieve the symptoms and prevent them from further. The kidneys that are small enough to heal themselves. The treatment varies according to the type of calculation and the severity of the symptoms. People with severe symptoms may need to be hospitalized. When healing, urine and calculation are to be analyzed to determine the type.
Drink at least 6-8 glasses of water a day to produce a large amount of urine. Some people may need to get intravenous fluids. Painkillers can help control the pain. Depending on the type of calculation, your doctor may prescribe medicines to decrease training or surgery to remove the material that is causing it. Medications may include:
Allopurinol (for uric acid calculations);
Antibiotics (for struvite calculations);
Sodium bicarbonate or sodium citrate.
Surgery is usually required if the calculation:
It's too big to go alone;
It is growing;
It blocks urine flow and causes an infection or kidney damage.
Today, most treatments are much less invasive than the past. They can be made:
Lithotripsy wave extracorporeal shock to remove small calculations near the kidney. This method uses ultrasound or shock waves to break the calculus that is released through urine;
Percutaneous nephrolitotomy is used for large calculations in or near the kidney. It is removed with an endoscope inserted into the kidney through a small opening;
Uretroscopy can be used for calculations at the lower part of the urinary tract;
Standard surgery (nephrolitotomy) may be necessary if other methods do not work or are not possible.
PROGNOSIS: Renal calculations are painful, but can usually be removed from the body without causing permanent damage. They tend to return, especially if the cause has not been found and cared for. Possible complications may be:
Decrease or loss of function in the affected area;
Kidney damage or scarring;
Return of calculation;
Urinary tract infections.
Contact a doctor if you have symptoms of kidney stones, if it comes back, the pain becomes painful, diuresis decreases, or other new symptoms develop.
PREVENTION: If you have had a previous case of calculations, drink plenty of fluids (6-8 glasses of water a day) to produce enough urine. Depending on the type of calculation, you may need to take medicines or other measures to prevent them from returning. You may need to change your diet.
Sources [MA Cameron, K. Sakhaee uric acid nefrolithiasis. Urol Clin North Am. 2007; Chandhoke PS. Appraisal of former stone applicants. Urol Clin North Am. 2007; http://health.nytimes.com/health/; Finkielstein VA. Strategies to Prevent Calcium Oxalate Calculation. CMAJ. 2006; Pietrow PK, Preminger GM. Evaluation and medical management of urinary lithiasis. In: Wein AJ, ed. Campbell-Walsh Urology. 9a ed. Philadelphia, PA: Saunders Elsevier, 2007]
Renal pelvis cancer (ureter cancer)
Renal pelvis or ureter cancer is the cancer that forms in the pelvis or the tube leading the urine from the kidney to the bladder.
Causes: Cancer can grow in the urine collection system, but it is rare. As a group, the renal pelvis and ureter tumors account for no more than 5% of all kidney and upper urinary cancers. It affects men more often than women and is more common in people over the age of 65. The kidneys and ureter tumors are usually transitional cell tumors. About 10% are squamous cell carcinomas. The causes of this tumor are not fully known. In the long term, kidney irritation from harmful substances can be a risk factor. This irritation may be caused by:
Promises to save lives and transforms the application of sunscreen into a game!
Exposure to certain dyes and chemicals used for the manufacture of leather, woven, plastic and rubber products;
Patients with a history of bladder cancer are at risk.
SYMPTOMS: The most common are:
Blood in the urine;
Burning, pain or discomfort with urination;
Dark or rusty urine;
Pain at the side;
Need to urinate frequently at night;
Inadvertent weight loss;
High frequency or urinary urgency;
DIAGNOSIS: A doctor will examine the abdomen with the feel. It will rarely find a mass or swelling in the kidneys. The patient may have blood in the urine. A complete hemocromocytometer (CBC) can show anemia. Cancer cells can be visualized in the following tests:
Urinary cytology (microscopic examination of cells), taken during a cystoscopy;
Urine cytology taken from a sample of urine.
The tumor, or signs of urinary tract obstruction, may be displayed with
Abdominal computerized tomography;
Magnetic resonance of the abdomen;
A radiography, TAC or magnetic resonance imaging in other areas of the body can prove that cancer has spread.
THERAPY: The goal of treatment is to eliminate cancer. Surgery to remove all or part of the kidney (nephrectomy) is usually recommended. This may include removal of bladder and tissues around it, or lymph nodes. If the tumor is in the urethra, it may be possible to remove it by keeping the kidney. When cancer has spread outside the kidney or ureter, chemotherapy is often used. Since these tumors are similar to a bladder cancer form, they are treated with a similar type of chemotherapy.
PROGNOSIS: Healing varies depending on the location of the tumor and if cancer has spread. Cancer in the kidney or ureter can be cured with surgery. Cancer that has spread to other organs is usually not curable. However, there are some exceptions. Possible complications may be:
Local tumor spread, with an increase in pain;
Contact a doctor if you have the symptoms listed above.
PREVENTION: Follow your doctor's advice regarding medicines, including analgesics. Stop smoking and wear protective equipment if you may be exposed to substances that are toxic to the kidneys.
Sources: [National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Cancer Bladder, Including Urothelial Tumor Machine Superiority and Prostate Cancer. National Comprehensive Cancer Network, 2008; http://health.nytimes.com/health/]
Muscle cramps are involuntary and often painful contractions of the muscles. Cramps are very common and can be stopped by stretching muscle. Muscle cramps may appear with hard or swollen muscles. They are not the same as muscle spasms.
CAUSES: Muscle spasms may cause cramps and are generally brought on by the following conditions:
Reducing magnesium or calcium levels in the body.
DIAGNOSIS: Your doctor will perform a physical examination and ask questions about the patient's medical history, related symptoms, any medications you take, and your daily habits, from alcohol abuse to posture during the day. Exams that can be made include
Blood tests for calcium, potassium, magnesium or metabolism problems, kidney and thyroid function;
THERAPY: Slow stretching often brings relief. If muscle cramps persist, are severe or frequently come back, consult your doctor. Painkillers or analgesics can be prescribed.
Sources: [Skorecki K, Ausiello J. Sodium homeostasis and water disorders. In: Goldman L, Ausiello D, eds. Goldman: Cecil Medicina. 23a ed. Philadelphia, PA: Saunders Elsevier, 2007; Rene B. Molitoris acute lesions. In: Goldman L, Ausiello D, eds. Goldman: Cecil Medicina. 23a ed. Philadelphia, PA: Saunders Elsevier, 2007; http://health.nytimes.com/health; Barohn R. Muscle Diseases. In: Goldman L, Ausiello D, eds. Goldman: Cecil Medicina. 23a ed. Philadelphia, PA: Saunders Elsevier, 2007]
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