Urinary calculi in the elderly
Introduction
Introduction to urinary calculi in the elderly Urinary calculi can be divided into upper urinary tract stones and lower urinary tract stones, upper urinary tract stones are located in the kidney and ureter, and lower urinary tract stones are located in the bladder and urethra. Therefore, lower urinary tract stones are one of the more common diseases in the elderly. basic knowledge Sickness ratio: 14% Susceptible people: the elderly Mode of infection: non-infectious Complications: hematuria hydronephrosis renal colic kidney stones bladder stones urinary tract infection
Cause
The cause of urinary calculi in the elderly
(1) Causes of the disease
The etiology of urinary calculi is complex, and there are many factors contributing to it. External factors are related to the natural and social environment. Internal factors are related to race, inheritance, eating habits, metabolic abnormalities and diseases, and the main causes of urinary calculi in the elderly. Have:
1. Lower urinary tract obstruction is the most important factor, such as benign prostatic hyperplasia, posterior urethral stricture and bladder diverticulum.
2. The elderly are less active or stay in bed for a long time
(1) It is not conducive to the downward flow of urine, forming urinary deposits.
(2) Decalcification of bones for depletion, which increases blood calcium and urinary calcium, and provides the possibility of stone formation.
(3) Indwelling catheter is prone to urinary tract infection and stones.
(4) The elderly sometimes have primary hyperthyroidism.
(two) pathogenesis
The formation of urinary calculi in the elderly is related to the following factors.
1 Prostatic hyperplasia causes lower urinary tract obstruction and infection.
2 Osteoporosis caused by fracture or sputum, increased free calcium, resulting in increased blood calcium and urinary calcium.
3 various reasons lead to poor urine flow caused by prolonged bed rest.
4 elderly patients with urinary tract infection due to indwelling catheter, and then induce urinary tract stones.
Prevention
Urinary calculi prevention in the elderly
1. Drink plenty of water and dilute the urine.
2. Encourage older people to exercise properly to avoid decalcification of bones.
3. Control the intake of animal protein and sugar.
Complication
Urinary calculi complications in the elderly Complications, hematuria, hydronephrosis, renal colic, kidney stones, bladder stones, urinary tract infection
Common hematuria, hydronephrosis, renal colic and so on.
Symptom
Urinary calculi in the elderly Symptoms Common symptoms Urine pain Bladder irritation Bladder stones Urinary frequency Abdominal urgency Urgency Severe pain Urine blood and urine Abdominal pain with hematuria
Kidney stones
(1) Clinically asymptomatic.
(2) If the stone is fixed in the renal pelvis or staghorn calculus, lumbar pain may occur: manifested as dull pain or cramp in the kidney area, and radiated down the ureteral area.
(3) Hematuria.
(4) Gastrointestinal reactions such as nausea and vomiting.
(5) Concomitant infection may be accompanied by chills, fever, accompanied by frequent urination, dysuria, urgency and pyuria.
(6) If there are stones or kidney stones on both sides, it will cause obstruction, affecting kidney function and causing urinary closure.
2. Ureteral stones
Primary ureteral stones are rare, and small stones that generally originate in the kidneys descend to the ureter.
(1) Renal colic.
(2) Hematuria.
(3) Sometimes accompanied by gastrointestinal symptoms such as nausea, vomiting and bloating.
3. Bladder stones
(1) dysuria and terminal hematuria.
(2) Sudden interruption of urine flow, which is a typical symptom of bladder stones, which can change urine and urinate.
(3) The combined infection has symptoms of bladder irritation and pyuria in the urine.
4. Urethral stones
Discharge into the urethra from the bladder
(1) The flow of urine suddenly stops during urination.
(2) The urine flow becomes fine or dripping.
(3) severe pain in the urethra, radiating to the head of the penis or the perineum.
(4) Stones can be touched in the anterior urethra.
Examine
Examination of urinary calculi in the elderly
1. There are small stones or sand-like stones in the medical history.
2. Urine routine examination has red blood cells, combined with infection, there are pus cells in the urine, need to be urinary bacterial culture, colony count and drug sensitivity.
3. X-ray inspection
(1) Abdominal plain films of the kidney, ureter and bladder area.
(2) Urinary urography: can understand the water accumulation in the kidney caused by stones.
(3) retrograde pyelography: can understand the location and obstruction of ureteral stones.
(4) CT scan: uric acid stones that are not developed on X-rays can be found. 2. Isotope renal examination shows upper urinary tract obstructive lesions and obstruction.
4. Bladder urethroscopic examination
Correct diagnosis of bladder and urethra stones can be made and the causes of stones, such as benign prostatic hyperplasia and bladder diverticulum in the elderly, can be made.
5. For elderly patients with double kidney stones or multiple recurrence stones, blood calcium and blood phosphorus should be examined, and calcium and phosphorus metabolism tests should be performed if necessary. Occasionally, urinary calculi in the elderly may also be caused by hyperparathyroidism.
Diagnosis
Diagnosis and diagnosis of urinary calculi in the elderly
diagnosis
1. History and clinical manifestations.
2. Abdominal plain film, 95% of the stones can be displayed on the X-ray, if the negative stone can be used for retrograde angiography.
3. Cystoscopy and ureteroscopy, in addition to assist in the diagnosis, some ureteral stones can also be removed.
Differential diagnosis
Clinical needs to be differentiated from urinary tumors, prostate diseases and metabolic diseases.
