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Urolithiasis

Roland W. Newman II, DO Reviewed 04/2024
 


BASICS

DESCRIPTION

  • Stone formation within the urinary tract: Urinary crystals bind to form a nidus, which grows to form a calculus (stone).

  • Range of symptoms: asymptomatic to obstructive; febrile morbid...

DIAGNOSIS

HISTORY

  • Pain

    • Renal colic: acute onset of severe groin and/or flank pain

    • Distal stones may present with referred pain in labia, penile meatus, or testis.

  • Microscopic/gross hematuria occurs in 95%...

TREATMENT

GENERAL MEASURES

  • 75% of patients are successfully treated conservatively and pass the stone spontaneously.

  • Most stones <5 mm will pass spontaneously with conservative treatment.

  • Stones betw...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Patients being treated conservatively should be followed until imaging is clear or stone is visibly passed.

    • Strain urine and send stone for composition.

    • Tamsulosin ...

REFERENCES

1
Bao Y, Tu X, Wei Q. Water for preventing urinary stones. Cochrane Database Syst Rev. 2020;2(2):CD004292.
2
Siener R. Nutrition and Kidney Stone Disease. Nutrients. 2021;13(6):1917. doi:10.33...

SEE ALSO

Algorithms: Dysuria; Renal Calculi; Urethral Discharge 

CODES

ICD10

  • N20.9 Urinary calculus, unspecified

  • N20.0 Calculus of kidney

  • N20.1 Calculus of ureter

  • N21.0 Calculus in bladder

  • N21.1 Calculus in urethra

  • N21.8 Other lower urinary tract calculus

  • N21.9 Calculus o...

CLINICAL PEARLS

  • Medical expulsive therapy may improve likelihood of spontaneous stone passage.

  • Increased fluid intake for life; 2-3 L/day intake.

  • Patients with calcium stones should minimize high-oxalat...

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