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    Can A Man Give Birth? Sure, To Kidney Stones
    By Enrico Uva | December 11th 2011 08:47 AM | 3 comments | Print | E-mail | Track Comments
    About Enrico

    I majored in chemistry, worked briefly in the food industry and at Fisheries and Oceans. I then obtained a degree in education. Since then I have...

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    If detective games were my passion, I would choose medical diagnosis over FBI investigations.  A single symptom can originate from a variety of causes. Combination of symptoms narrow the range of possibilities. Then analytical tests help zero in on the target, which can remain elusive in the case of rare or undiscovered diseases.

    For a brief period of time you could mistake the initial symptom of passing a kidney stone with a backache.  Soon there is uncomfortable urination and possibly blood, especially when the stone is caught in the ureter.  And then the signature, almost in-labor-like experience sets in. Spasmodic, the pain reverberates from the flank to the genitals. No lying position can alleviate it. Relying on a heavy dose of Tylenol for relief is like attempting to put out a bonfire with piss. Only morphine works. When the doctor at the clinic applied pressure to my back with his palm and braced himself for possible vomiting, and I did almost retch, he declared with confidence, "You are passing a kidney stone."
    The symptoms in my anecdote are consistent with those described in the Merck Manual.

    When colic pain is accompanied by flank or costovertebral angle(CVA) tenderness, increased sensitivity in the lumbar or groin areas or complaints of genital pain with no lesions, kidney stones are likely the cause.

    Note that CVA tenderness alone does not necessarily spell out kidney stones because it can also be brought about by both kidney infections and renal artery/vein occlusions.

    How do analyses confirm the presence of stones, which hospitalize one in every thousand Americans and which show in about 1% of autopsies? (That's not to imply that they are a common cause of death ; small ones often go unnoticed, hence the possibility of dieing before they become symptomatic.) Urine will often be tainted with either visible or microscopic red blood cells and with white blood cells and bacteria. Crystalline substances (stone fragments) are at times present in the sediment and they are subsequently analyzed with crystallography. X Rays reveal the presence of most stones except those that are almost pure uric acid.

    The Various Types and Causes of Stones

    1. Calcium Oxalate Stones   These so-called "calcium stones consist of the negative oxalate ion(C2O42-) bound to the calcium ion(Ca2+). If the body had a way of generating highly reactive elemental calcium, it would have far more than blockage problems. Calcium oxalate's solubility is fairly low(about 1.9 mg per 100 ml) so when both ions coexist most will precipitate. (Complete photos of kidney stones can be found here.)
    Causes
    a) Although not the primary cause of this type of stone, excess hormonal secretions from the parathyroid gland can elevate calcium ion excretion.
    b)  A far more common cause, accounting for about half of male cases and three quarters of female stones, is a hereditary condition that elevates urinary calcium ion levels to more than 4 mg daily per kg of body weight. For such patients, increased water intake is recommended with K+ supplements, if necessary.
    c) Low levels of citrate ion can form stones because normally citrate interferes with the calcium- oxalate equilibrium. An intake of calcium citrate solution can alleviate the disorder.
    d)In hyperoxaluria, there is too much oxalate in the urine. with levels exceeding 40 mg/day. The condition is exacerbated by diet. According to the  latest analyses, the servings with more than 100 mg include mixed nuts, rhubarb, spinach, Swiss chard, sesame seeds, chocolate soy milk, almonds and beets.
    2. Uric Acid Stones  Uric acid is a form of nitrogenous waste also implicated in gout. When it shows up in urine it's because of a combination of genetics and high dietary intake through fish, meat and poultry. Microscopic crystals of uric acid can serve to nucleate or seed the growth of the more common calcium oxalate crystals. This has thrown off diagnoses in the past. NaHCO3 and potassium citrate are prescribed because if the urine's pH is increased, the compound's solubility will increase.
    3. Cysteine Stones Cysteine is a dimeric amino acid, and such stones formed by a recessive genetic trait have a rounded, glass appearance. Excessive cysteine in the urine can be detected by the
    cyanide-nitroprusside test. (One of the components of that reagent is used in forensics to detect illicit drugs.) These stones show up in the renal pelvis or bladder and renal colic is the most common symptom.
    4. Magnesium Ammonium Phosphate Stones  These are formed form the combination of
    urinary tract infections and bacteria that convert the common nitrogenous waste urea to ammonium ion, a process mirrored in the nitrogen cycle in soil. This form of stone occurs primarily in women.

    In general only 20% of kidney stone cases occur among women, and for that unfortunate group, many have to bear the burden of giving birth to both children and stones.

    Comments

    What happened to zapping them with ultrasound ??

    UvaE
    Ultrasound is used for larger stones; I was just looking at preventive measures.
    Nice article, Enrico, but I would have said that the pain of an attack corresponds roughly to being kicked in the crotch for about three hours. For a guy, that is.