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Urolithiasis

Roland W. Newman II, DO and Jana W Qiao, MD Reviewed 06/2022
 


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 less than 5 mm will pass spontaneously with conservative treatment.

  • Stones...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Patients with ureteric stones who are being treated conservatively should be followed until imaging is clear or stone is visibly passed.

    • Strain urine and send ston...

REFERENCES

1
Corbo J, Wang J. Kidney and Ureteral Stones. Emerg Med Clin North Am. 2019 Nov;37(4):637-648.
2
Bao Y, Tu X, Wei Q. Water for preventing urinary stones. Cochrane Database Syst Rev. 2020 Feb ...

ADDITIONAL READING

Campschroer T, Zhu X, Vernooij RW, Lock MT. Alpha-blockers as medical expulsive therapy for ureteral stones. Cochrane Database Syst Rev. 2018 Apr 5;4(4):CD00850...

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

  • Incidence in industrialized countries seems to be increasing, probably due to improved diagnostics as well as to increasingly rich diets.

  • Vesical calculosis (bladder stones) due to maln...

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