Kidney Stones And What Causes Them

Kidney stones many times have no particular, single trigger, although a number of factors might increase your chances. Here’s some information from Metropolitan Urological Specialists in St. Louis, MO about some of those factors.

Kidney stones form whenever your urine contains more crystal-forming substances -- such as calcium, oxalate, and uric acid -- than the fluid in your urine can dilute. At the same time, your urine might lack substances that prevent crystals from sticking together, creating a perfect environment for kidney stones to form.

Knowing the kind of kidney stone helps identify the cause and may also give clues on exactly how to lower your risk of getting more kidney stones. Varieties of kidney stones include:

•   Calcium stones. Most kidney stones are calcium stones, normally as calcium oxalate. Oxalate is a natural substance found in food. Some fruits and veggies, and nuts and chocolate, have high oxalate levels. Your liver also generates oxalate. Dietary factors, high doses of vitamin D, intestinal bypass surgery, and numerous metabolic disorders can increase the concentration of calcium or oxalate in urine. Calcium stones might also show up in the form of calcium phosphate.
•   Struvite stones. Struvite stones form in response to an infection, like a urinary tract infection. These stones can grow quickly and get quite large, sometimes with very few symptoms or little warning.
•   Uric acid stones. Uric acid stones can develop in individuals who don't drink enough fluids or who lose too much fluid, those who have a high-protein diet, and those who have gout. Certain genetic factors can also boost your risk of uric acid stones.
•   Cystine stones. These stones form in individuals with a hereditary disorder that causes the kidneys to excrete too much of certain amino acids (cystinuria).
•   Other stones. Other, rarer types of kidney stones also can occur.

Factors which increase kidney stone risk for people in St. Louis, Creve Coeur, Florissant, and Kirkwood, MO include:

•   Family or personal history. If somebody in your family has kidney stones, you're more likely to develop stones, as well. And if you have already had one or more kidney stones, you are at increased risk of developing another.
•   Dehydration. Not drinking enough water each day increases your chance of kidney stones. People who live in warm environments and those who sweat a good deal might be at greater risk than other people.
•   Certain diets. Eating a diet that is loaded with protein, sodium, and sugar may raise your risk of some types of kidney stones. This is especially true with a high-sodium diet. Too much sodium in what you eat raises the amount of calcium your kidneys must filter and substantially increases your risk of kidney stones.
•   Obesity. High body mass index (BMI), large waist size, and gaining weight have been connected to a greater risk of kidney stones.
•   Digestive diseases and surgery. Gastric bypass surgery, inflammatory bowel disease, or chronic diarrhea can cause changes in the digestive process which affect your absorption of calcium and water, increasing the levels of stone-forming substances within urine.
•   Other medical conditions. Diseases and conditions that may increase your risk of kidney stones include renal tubular acidosis, cystinuria, hyperparathyroidism, specific medications, and some urinary tract infections.

If you think that you might have a kidney stone, the best thing you can do is see a doctor. The experts at Metropolitan Urological Specialists have many years of combined experience helping patients with kidney stones and a number of other urological health problems.

Tips for Talking to Your Doctor about OAB

If you've got urinary symptoms, make bladder worries the main target of your next doctor appointment.

Overactive bladder is a common problem. Generally, people wait seven years prior to seeking treatment for urinary control problems, according to a recently available survey by the National Association For Continence. If you've got OAB, these basic steps from Metropolitan Urological Specialists in St. Louis, Missouri will help you get the best results from your next doctor's appointment.

1. See an expert. Your primary care physician could be a good place to start. Nevertheless, not all doctors are well-trained in diagnosing and treating incontinence. If your family doctor or gynecologist isn't, consider going to Metropolitan Urological Specialists if you live in St. Louis, Creve Coeur, Florissant, Kirkwood, Crestwood, Chesterfield, or Washington, Missouri.

2. Take note. One of the most important things to do is log your bathroom habits. This gives your physician an extensive picture of the symptoms you're experiencing and can help her get right to the source of the problem. Keep a bladder diary for two or three days prior to your visit. In it, note:

•   when you urinate,
•   whether you urinate a lot or a little every time,
•   what you eat and drink throughout each day,
•   the number of accidents you experience,
•   activities that seem to lead to leakages, and
•   whether each leak is small, moderate, or large.
In addition to a bladder diary, give your doctor a list of all medications you take, including over-the-counter and herbal products. Also, list medical procedures you have had (including vaginal births).

3. Know yourself. Create a list of the 3 to 5 most annoying problems related to your bladder problems and share it during your appointment. Maybe you do not leave home without knowing the precise location of every toilet along your route or you no longer get involved in activities that you enjoy, like tennis or golf.

4. Set goals. Come into your appointment with a couple of very clear goals in mind. Maybe you want to be taken seriously or you want to leave the office with a game plan, or you have a very personal goal, like being able to wear white pants without fear of leakage. Remember, you and your doctor are a team, so be open with her about your wishes.

5. Train your bladder with an expert. If you've had little success with the pelvic floor exercises known as Kegels, tell the doctor. Many times, women who are self-taught have been doing them incorrectly. Your physician can make it easier to find out how to do them properly and can teach you proper technique and how to hone in on the right muscle groups.

If you've got overactive bladder, take the first step and visit a doctor. Metropolitan Urological Specialists in St. Louis, MO is a group of dedicated and experienced doctors ready to help you stop thinking about your overactive bladder and get back to thinking about living your life.

Overactive Bladder Diagnosis

Diagnosis of overactive bladder is step one to finding the right treatment for it. Here are some of the tests that will be considered if you visit Metropolitan Urological Specialists. They serve patients in St. Louis, Creve Coeur, Florissant, and Kirkwood, Missouri.

A complete health history, including a voiding diary; a physical assessment; and one or more diagnostic procedures can help your health care provider diagnose any underlying condition and devise a suitable treatment plan for overactive bladder.

Medical History

The medical history includes information regarding bowel habits, patterns of urination and leakage (when, how often, how severe), and whether there is pain, discomfort, or straining when voiding. A history of health complications, pelvic surgeries, pregnancies, and list of medications (prescription and over-the-counter) also can supply information relevant to creating a diagnosis. In seniors, a mental status evaluation and evaluation of social and environmental factors also may be performed.

Physical Examination

A physical examination includes a neurologic status evaluation and examination of the abdomen, rectum, genitals, and pelvic area. The cough stress test, where the patient coughs forcefully while the physician observes the urethra, enables observation of urine loss. Immediate leakage with coughing indicates a diagnosis of stress incontinence. Leakage which is delayed or persistent after the cough indicates urge incontinence.

The physical examination also helps the physician identify health problems which can be the cause of overactive bladder. For example, poor reflexes or sensory responses may suggest a neurological disorder.

Urinalysis

Examination of the urine might identify health problems connected with overactive bladder, including the following:

•   Bacteriuria-presence of bacteria in urine; indicates infection
•   Glycosuria-excess glucose within urine; may indicate diabetes
•   Hematuria-blood in urine; may indicate kidney disease
•   Proteinuria-excess protein within urine; might point to kidney disease, cardiac disease, blood disease
•   Pyuria-presence of pus in urine; suggests infection

Specialized Testing

If overactive bladder continues on after diagnosis and treatment, further testing may be required. Urologists perform urodynamic, endoscopic, and imaging tests to obtain a more extensive evaluation of the lower urinary tract to figure out a new treatment plan.

Postvoid Residual Volume (PRV)

This procedure requires catheterization or pelvic ultrasound. The patient voids right before the PRV is measured. This initial void is observed for hesitancy, straining, or interrupted flow. A PRV lower than 50 mL indicates adequate bladder emptying. Recurring measurements of 100 to 200 mL or higher represent inadequate bladder emptying. The clinical setting and the individual's readiness to void might affect the test result; therefore, repeated measurements may be necessary.

Urodynamic Testing

Cystometry might be used to appraise the anatomic and functional status of the bladder and urethra. The cystometer is an instrument that measures the pressure and capacity of the bladder; thus evaluating the function of the detrusor muscle. Simple cystometry detects unusual detrusor compliance, but abdominal pressure isn't included and the results need to be evaluated with caution.

The multichannel, or subtracted, cystometrogram concurrently measures intra-abdominal, total bladder, and true detrusor pressures. This allows involuntary detrusor contractions to be differentiated from increased intra-abdominal pressure. The voiding cystometrogram registers outlet obstruction in patients who are able to void.

Uroflowmetry identifies unusual voiding patterns. Urethral pressure profilometry measures the resting and dynamic pressures within the urethra.

Endoscopic Tests

Cystoscopy may be carried out when urodynamic testing fails to duplicate symptoms, when the patient encounters new symptoms (e.g., cystitis, pain), or whenever urinalysis reveals a disease process (e.g., henaturia, pyuria). Cystoscopy identifies the presence of bladder lesions (e.g., cysts) and foreign bodies (e.g., stones).

Imaging Tests

X-rays and ultrasound can be used to evaluate anatomic conditions connected with overactive bladder. Imaging of the lower urinary tract before, during, and after voiding is useful in examining the anatomy of the urinary bladder and urethra.

If you think that you may have overactive bladder and want answers, visit Metropolitan Urological Specialists in St. Louis, MO and schedule an appointment.