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Urolithiasis

Roland W. Newman II, DO and Jana W Qiao, MD Reviewed 05/2023
 


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.

  • >65% of stones <5 mm will pass spontaneously with conservative treatment .

  • Stone...

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
Yi X, Cao D, You P, et al. Comparison of the Efficacy and Safety of Extracorporeal Shock Wave Lithotripsy and Flexible Ureteroscopy for Treatment of Urolithiasis in Horseshoe Kidney Patien...

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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