Elderly urinary system stones

　　The etiology of urinary system stones is relatively complex and is caused by multiple factors. External factors are related to the natural and social environment, while internal factors are related to race, genetics, dietary habits, metabolic abnormalities, and diseases. The main reasons for the occurrence of elderly urinary system stones mainly include lower urinary tract obstruction and elderly inactivity or long-term bed rest.

　　The main harm of urinary system stones to health is manifested in three aspects: local injury caused by stones, urinary tract obstruction caused by stones, and concurrent urinary tract infection:

　　1. Local injury

　　Small stones can move freely within the urinary tract and are prone to injure the urinary tract mucosa, causing bleeding and renal colic, but this local injury is relatively mild. Large, fixed, or staghorn urinary system stones, although the pain is not severe, can compress the urinary tract mucosa for a long time, causing epithelial shedding, tissue ulceration, and even adhesion between the stone and the ureteral wall. In severe cases, it may also cause cancer.

　　2. Ureteral obstruction

　　Kidney and ureteral stones are most likely to be located at the renal pelvis ureteral junction (the first stricture), where the ureter crosses the iliac vessels (the second stricture), and at the ureteral bladder entrance (the third stricture), causing urinary tract obstruction. After urinary tract obstruction, the upper ureter and renal pelvis above the obstruction will dilate and accumulate fluid. Hydronephrosis can be divided into mild, moderate, and severe hydronephrosis. When hydronephrosis occurs, the renal parenchyma is compressed, affecting renal function. If hydronephrosis is not relieved for a long time, severe cases can cause the entire kidney to lose function. In cases where both urinary tracts are severely obstructed, it may also lead to uremia.

　　3. Urinary tract infection

　　Ureteral obstruction complicated with bacterial infection and secondary infection after hydronephrosis can lead to pyelonephritis. Severe urinary tract infections may also cause sepsis, threatening human life. In addition, urinary tract infections also promote the formation of stones, causing the original stones to increase in size rapidly. Therefore, once urinary system stones are found, they should be treated with sufficient attention and active treatment.

　　According to the location of the stones, patients may have different symptoms. The following common symptoms are introduced as follows:

　　1. Renal stones

　　1. Clinically, there may be no symptoms.

　　2. Back pain may occur if the stone is fixed in the renal pelvis or in the form of a horn-like stone.

　　3. Hematuria may occur.

　　4. Nausea and vomiting may occur.

　　5. Chills, fever, and symptoms such as frequent urination, dysuria, urgency, and purulent urine may occur with infection.

　　6. Urinary retention may occur if stones are present in both kidneys simultaneously or in a solitary kidney.

　　2. Ureteral stones

　　Primary ureteral stones are rare and generally originate from small stones in the kidney descending into the ureter.

　　1. Renal colic.

　　2. Hematuria.

　　3. Sometimes accompanied by nausea, vomiting, and abdominal distension and other gastrointestinal symptoms.

　　3. Bladder stones

　　1. Dysuria and terminal hematuria.

　　2. Sudden interruption of urine flow is a typical symptom of bladder stones, and urination can be resumed by changing body position.

　　3. Bladder irritation symptoms may occur with infection, and there may be purulent urine.

　　4. Urethral stones

　　1. The urine flow suddenly stops during urination.

　　2. The urine flow becomes thin or dribbling.

　　3. Severe urethral pain, radiating to the glans penis or perineum.

　　4. Stones can be felt in the anterior urethra.

　　Reasonable prevention can reduce the occurrence of diseases. In order to prevent the occurrence of elderly urinary system stones, it is recommended that everyone should pay attention to the following lifestyle issues:

　　1. Pay attention to dietary structure

　　The formation of urinary stones is related to dietary structure, therefore, adjusting the dietary structure can prevent the occurrence of stones.

　　2. Actively treat the primary disease

　　Many diseases can lead to the occurrence of stones, therefore, actively treating the primary disease is also an important method for preventing urinary system stones.

　　3. Prevention and treatment of urinary tract infection

　　Urinary tract infection is a major local factor in the formation of urinary stones and is directly related to the prevention and treatment effect of urinary stone disease, therefore, preventive work should be done well.

　　Elderly urinary system stones usually have obvious symptoms, and this disease can be diagnosed by the following examinations in general:

　　1. Medical history

　　The patient has a history of excreting small stones or sand-like stones.

　　2. Urinalysis

　　Red blood cells are present in the urine, and pus cells are present in the urine when infected, and urine bacterial culture, colony count, and drug sensitivity test are required.

　　3. X-ray examination

　　X-ray examination can understand the location and shape of the stones.

　　4. Cystoscopy

　　Cystoscopy can make an accurate diagnosis of bladder and urethral stones and understand the causes of stones, such as benign prostatic hyperplasia and bladder diverticula in the elderly.

　　Patients with this disease should eat light vegetables and eat more watermelons, winter melons, pears, fresh lotus roots, and other foods. If stones have been excreted, further examination should be conducted to determine the type of stone, and different dietary plans should be adopted according to the type of stone.

　　1. Oxalate Stones

　　For this type of stone, avoid eating bamboo shoots, spinach, soybeans, beets, tomatoes, rhubarb, apples, cocoa.

　　2. Uric Acid Stones

　　For this type of stone, eat less meat, animal internal organs, lentils, fish, black tea, cocoa, coffee, and chocolate. Eat more corn flour, oatmeal, pollen, eggs, fruits, beets, carrots, celery, cucumbers, eggplants, sweet potatoes, pumpkins, and drink more tea.

　　3. Phosphate stones

　　This type of stone can eat acidic foods such as black plums, plums, and walnuts; calcium-rich foods such as milk, cheese, and beans.

　　According to the specific situation of the disease, the treatment of this disease can adopt two methods: non-surgical treatment and surgical treatment. The following is a specific introduction:

　　First, Non-surgical Treatment

　　Non-surgical treatment is generally suitable for calculi with a diameter less than 1 centimeter, smooth edges, no obvious urinary tract obstruction, and no infection. For some large horn-shaped renal calculi that do not cause symptoms in clinical practice, non-surgical treatment can also be temporarily adopted.

　　1. Increase water intake: Increase urine volume to flush the urinary tract, promote the downward movement of calculi, dilute urine to reduce crystal precipitation.

　　2. Traditional Chinese medicine treatment: In daily life, tea as a drink can not only prevent and improve the treatment of calculi but also regulate the balance of the human body's mechanism and enhance the body's resistance. This kind of traditional Chinese medicine tea mainly includes dandelion, honeysuckle, coptis, etc.

　　3. Acupuncture method: Increase the peristalsis of the renal pelvis and ureter, which is conducive to the excretion of calculi.

　　4. Regularly perform jumping exercises, or perform inverted posture and striking exercises for calculi in the renal calyces, which is also beneficial for the excretion of calculi.

　　5. Other: For patients with bacterial infection in urine culture, select sensitive drugs (Aureomycin, Metronidazole) for active anti-infection. For those with metabolic disorders, it is necessary to actively treat the primary disease and regulate the acidity and alkalinity of urine, etc.

　　Second, Surgical Treatment

　　For those affected by urinary tract obstruction caused by calculi that have affected renal function, or those who have failed to respond to non-surgical treatment, surgical treatment should be considered. It is necessary to understand the bilateral renal function before surgery, and for those with infection, antibiotics should be used to control the infection first. Patients with ureteral calculi should have an intravenous pyelography before entering the operating room or on the operating table to locate the calculi finally.