Ureteric Stones Treatment | Allen Sim Urology

Ureteric Stones

What are Ureteric Stones?

Ureteric stones, commonly referred to as ureteral stones, are hard mineral deposits that develop in the urinary tract. These stones typically form in the kidneys and travel down the ureters, which are the slender tubes connecting the kidneys to the bladder. When these stones become lodged in the ureters, they can obstruct urine flow and cause intense discomfort.

Composition of ureteric stones

Ureteric stones vary in size, shape, and composition, with the most common types being:

Calcium stones

Composed primarily of calcium oxalate or calcium phosphate, these are the most prevalent types, often linked to high calcium or oxalate levels in the urine.

Uric acid stones

Formed when urine becomes excessively acidic, commonly associated with diets rich in purines (found in red meat and shellfish) and conditions like gout.

Struvite stones

Typically seen in individuals with recurrent urinary tract infections (UTIs), these stones are composed of magnesium ammonium phosphate.

Cyctine stones

Rare stones caused by a genetic disorder called cystinuria, which leads to excessive cystine in the urine.

Ureteric stones can range from tiny grains resembling sand to larger masses that obstruct the ureter entirely. Stones smaller than 5mm in diameter may pass on their own, but larger stones often require medical intervention due to their potential to block urine flow, cause infection, or damage the kidneys.

What causes Ureteric Stones?

Ureteric stones form when certain substances in urine, such as calcium, oxalate, uric acid, or cystine, become overly concentrated and crystallise. Under normal conditions, urine contains compounds that dilute these substances and inhibit crystal formation. However, factors such as dehydration, high dietary intake of stone-forming minerals, or imbalances in urinary pH can disrupt this delicate balance.

When urine becomes supersaturated with these minerals, they begin to aggregate into crystals, which can grow over time to form stones. Additionally, reduced levels of natural inhibitors in the urine—such as citrate—can further promote stone formation.

Conditions like recurrent urinary tract infections (UTIs) or metabolic disorders, such as hyperparathyroidism and gout, can also create an environment conducive to stone development. The process often begins in the kidneys, but as the stones travel down the ureters, their size and location may lead to obstruction, causing pain and other symptoms.

What are the symptoms of Ureteric Stones?

Ureteric stones can cause a range of symptoms, varying in intensity based on the stone’s size, location, and degree of obstruction. Recognising these signs early can help ensure timely diagnosis and treatment.

Severe pain – intense, cramping pain typically felt in the lower back, abdomen, or side, often radiating to the groyne.
Haematuria – blood in the urine, which may appear pink, red, or brown.
Urinary urgency and frequency — a persistent need to urinate, even with little urine output.
Painful urination — burning or discomfort while passing urine.
Nausea and vomiting — often accompanying episodes of severe pain.
Fever and chills — indicating a possible infection requiring immediate medical attention.
Difficulty passing urine — obstruction can lead to reduced or blocked urine flow.

If any of these symptoms occur, you must seek medical attention promptly to prevent complications.

Who is at risk of Ureteric Stones in Singapore?

Certain individuals are more likely to develop ureteric stones due to lifestyle, dietary habits, or underlying health conditions. The group of individuals include:

Individuals with low fluid intake

Dehydration is a common cause, particularly in Singapore’s humid climate, where inadequate hydration can lead to concentrated urine.

High-sodium or high-protein diets

Diets rich in sodium or animal proteins, common in modern diets, can increase calcium excretion and uric acid levels, promoting stone formation.

Family history of stones

A genetic predisposition can significantly raise the risk of developing ureteric stones.

Those with sedentary lifestyles

Reduced physical activity can contribute to stone formation by slowing metabolism and urine flow.

Individuals with metabolic disorders

Conditions like hyperparathyroidism, gout, or cystinuria increase susceptibility.

Recurrent urinary tract infections (UTIs)

Chronic UTIs can lead to struvite stones.

Obesity or weight fluctuations

Rapid weight changes or obesity can alter metabolic processes and elevate stone risk.

Patients on certain medications

Drugs like diuretics or calcium-based antacids may increase the likelihood of stone formation.

How are Uretetic Stones diagnosed?

At Allen Sim Urology, we prioritise accurate and efficient diagnosis to ensure optimal outcomes for our patients. Our comprehensive diagnostic approach uses specialised tools and techniques to identify ureteric stones and their impact on your health, such as:

01. Non-contrast CT scan

This is the primary diagnostic test for detecting ureteric stones, providing detailed images to determine the stone’s size, location, and composition.

02. Ultrasound

A radiation-free alternative, especially suitable for pregnant women or children, to visualise stones and assess the urinary tract.

03. X-rays (KUB)

Used in specific cases to identify larger stones or monitor their progression.

04. Urinalysis

A laboratory test to detect blood, crystals, or signs of infection in the urine, which can provide insights into the stone’s nature.

05. Blood tests

These help evaluate kidney function and identify metabolic conditions that may contribute to stone formation.

05. Intravenous urogram (IVU)

In some cases, this imaging method helps visualise the urinary tract to identify obstructions caused by stones.

What are the treatment options for Ureteric Stones in Singapore?

At Allen Sim Urology, we offer a range of effective treatment options for ureteric stones, customised to suit the size, location, and severity of your condition. Our goal is to relieve your discomfort and restore your urinary health with optimal results. Your doctor may recommend the following:

Managing symptoms

For smaller stones, we may recommend increased fluid intake, pain management, and medications such as alpha-blockers to facilitate natural stone passage.

Extracorporeal Shock Wave Lithotripsy (ESWL)

This non-invasive procedure uses shock waves to break stones into smaller fragments, which makes them easier to pass naturally.

Ureteroscope

A minimally invasive endoscopic technique where we use a thin scope to locate the stone and remove it or fragment it with a laser.

Percutaneous Nephrolithotomy (PCNL)

For larger or more complex stones, we perform a small incision in the back to remove the stone directly, which ensures minimal disruption to your daily life.

Stent placement

In cases of severe obstruction or infection, we may place a temporary stent in the ureter to relieve blockages and facilitate urine flow.

Medications and dietary advice

Beyond immediate treatment, we provide tailored guidance to prevent future stone formation through medical management and lifestyle modifications.

At Allen Sim Urology, we focus on providing precise diagnoses and effective treatments tailored to your unique needs.

If you are experiencing symptoms of ureteric stones or need expert advice, schedule a consultation with Allen Sim Urology today for personalised care and effective solutions.

Frequently Asked Questions (FAQs)

01. How long does it take to pass a ureteric stone?

The time required to pass a ureteric stone depends on its size and location. Stones smaller than 5mm often pass spontaneously within a few weeks, while larger stones may require medical intervention.

02. Can ureteric stones recur after treatment?

Yes, individuals who have had ureteric stones are at a higher risk of recurrence. Implementing preventive measures, such as dietary modifications and staying well-hydrated, can help reduce this risk.

03. Are there any dietery restrictions to prevent ureteric stones?

Limiting intake of high-oxalate foods (like spinach and nuts), reducing sodium consumption, and moderating animal protein intake can help prevent stone formation. Increasing fluid intake is also crucial.

04. What complications can arise from untreated ureteric stones?

If left untreated, ureteric stones can lead to urinary tract infections, kidney damage, or hydronephrosis (swelling of the kidney due to urine buildup).

05. Is it possible to have ureteric stones without symptoms?

Yes, small ureteric stones may not cause noticeable symptoms and can pass unnoticed. However, larger stones are more likely to cause discomfort and complications.

06. How are ureteric stones different from kidney stones?

Kidney stones form within the kidneys, while ureteric stones are those that have moved from the kidneys into the ureters. The term “ureteric stones” specifically refers to stones located in the ureters.

07. Can children develop ureteric stones?

Although less common, children can develop ureteric stones, often due to genetic factors, dietary habits, or underlying medical conditions.

08. How can I tell if a ureteric stone has passed?

Passing a stone is often accompanied by relief from pain and other symptoms. You may also notice the stone in your urine. If symptoms persist, consult your healthcare provider.