7. Urolithiasis (Kidney Stones) Flashcards
What percentage of the populations present with Kidney Stones?
2-3%
What is the recurrence rate of Kidney Stones, within 10 years?
50%
Are Kidney Stones more common in Males or Females?
Males - 3 times more common - 1:8 lifetime risk
What is the peak age of onset for Kidney Stones in males?
30 years old
What are the peak ages for Kidney Stones in females?
- 35 years old (peri-menopausal)
2. 55 years old (post-menopausal)
What are the different stone types? And what are there relative incidences?
- Calcium Oxalate - 45%
- Calcium Oxalate + Phosphate - 25%
- “Triple Phosphate” - 20%
- Uric Acid - 5%
- Calcium Phosphate - 3%
- Cystine - 3%
What is the pathology of Kidney Stones?
- Due to a blockage / obstruction of urine, urine sits for excessive time in a certain place, which allows sediment to form.
- This sediment can coagulate to form Kidney Stones
What are the clinical features of Kidney Stones?
- Pain
- Ureteric Colic
- Dysuria
- Haematuria
- Recurrent UTI’s
- Pyrexia
How is the pain described?
Fixed in the loin but can occur in the Testicles / Vulva
Where can the Ureteric Colic radiate to?
The Groin
What investigations are necessary for Kidney Stones?
1, Blood Tests
- Urinalysis and Culture
- Intravenous Urogram
- Renal Ultrasound
- Plain X-Ray
- CT-KUB
What blood tests will occur? And what will they be looking for?
- Full Blood Count - Signs of Infection
- Urea, Electrolytes and Creatinine - To assess Renal Function
- Calcium, Albumin and Urate - To assess for Renal Dysfunction
- Parathyroid Hormone - To assess as an aetiology for Renal Damage
What is the purpose of the Urinalysis and Culture?
To exclude a UTI as a cause
What is the purpose of an Intravenous Urogram / Renal Ultrasound?
To assess for a stone
What is the best test for identifying a kidney stone?
CT-KUB
Followed by a Plain X-Ray
What treatments are required for Kidney Stones?
- Endoscopic Surgery
- Extracorporeal Shock Wave Therapy (ESWT)
- Percutaneous Nephrolithotomy (PCNL)
- Open Surgery:
a) Simple Partial Nephrectomy
b) Total Nephrectomy
How are most bladder stones treated?
Endoscopic Surgery
How does Extracorporeal Shock Wave Therapy work?
This uses shock waves to crush the stones into passable abjects
When is Percutaneous Nephrolithotomy used?
For a large stone when Extracorporeal Shock Wave Therapy is not an option
This is used alongside a Radiologist
When is open surgery used? What is the advantage / disadvantage?
Very rarely
Advantage - Least recurrence rate
Disadvantage - more risks / worse scar
