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Urolithiasis

Phillip Fournier, MD Reviewed 06/2018
 


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 morbidi...

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 9...

TREATMENT

GENERAL MEASURES

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

  • Stones that do not pass usually require surgical intervention.

  • 30–50% of patients will...

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 st...

REFERENCES

1
Matlaga BR, Shore AD, Magnuson T, et al. Effect of gastric bypass surgery on kidney stone disease. J Urol.  2009;181(6):2573–2577. [View Abstract on OvidMedline]
2
Scales CDJr, Curtis ...

ADDITIONAL READING

  • Penniston KL, Jones AN, Nakada SY, et al. Vitamin D repletion does not alter urinary calcium excretion in healthy postmenopausal women. BJU Int.  2009;104(10):1512–1516. [View...

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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