Urolithiasis

Urolithiasis refers to the formation of stones (calculi) within the urinary tract, including the kidneys, ureters, bladder, and urethra. These stones can cause significant pain, urinary obstruction, and other complications if not treated properly.

Symptoms

Severe Pain

Often described as sharp or cramping, typically starting in the back or side and radiating to the lower abdomen and groin (known as renal colic).

Hematuria

Blood in the urine, which may appear pink, red, or brown.

Urinary Frequency and Urgency

Frequent need to urinate or a persistent urge to urinate.

Painful Urination

Discomfort or burning sensation during urination.

Nausea and Vomiting

Often accompanying and/or caused by the severe pain.

Fever and Chills

May indicate a concurrent urinary tract infection.

Causes

Dietary Factors

High intake of oxalate-rich foods, excessive salt, and low water consumption.

Genetic Predisposition

Family history of kidney stones.

Metabolic Conditions

Conditions like hyperparathyroidism, which increase calcium levels in the blood.

Medical Conditions

Such as gout, which increases uric acid levels.

Urinary Tract Infections

Can lead to struvite stone formation.

Risk Factors

Dehydration

Insufficient fluid intake leads to concentrated urine.

Diet

High protein, sodium, and sugar intake.

Obesity

Increases the risk of stone formation.

Certain Medications

Some diuretics, calcium-based antacids, and other drugs can increase the risk.

Investigations

Medical History and Physical Examination

Insufficient fluid intake leads to concentrated urine.

Urine Analysis


To detect blood, crystals, and possible infection.

Imaging Studies

CT Scan: Most accurate for detecting stones.

Ultrasound: Used to identify stones and obstructions, especially in pregnant women.

X-ray (Kidney Ureter Bladder): To detect radiopaque stones.

Management

Management of urolithiasis can involve:

Flexible or Semi-Rigid Ureteroscopy

A surgical procedure using a scope inserted through the urethra to remove or break up kidney stones.

Cystolitholapaxy

A surgical procedure involving the insertion of a cystoscope into the bladder to break and remove bladder stones.

Extracorporeal Shock Wave Lithotripsy (ESWL)

Non-invasive procedure using shock waves to break stones into smaller pieces that can be passed in the urine.

Percutaneous Nephrolithotomy

Surgical removal of large kidney stones through a small incision in the lower back.

Medications

To manage pain (NSAIDs, opioids), facilitate stone passage (alpha-blockers), and prevent recurrence (thiazide diuretics, potassium citrate).

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