EAU 2020 Urolithiasis Flashcards
Non-infection stones
Calcium oxalate
Calcium phosphate
Uric acid
Infection stones
MAP
Carbonate apatite
Ammonium urate
Stones from Genetic causes
Cystine
Xanthine
2,8-Dihydroxyadenine
MINERAL NAME
Calcium oxalate monohydrate
Whewellite
MINERAL NAME
Calcium oxalate dihydrate
Weddelite
MINERAL NAME
Basic calcium phosphate
Apatite
MINERAL NAME
Calcium hydroxyl phosphate
Carbonate apatite
MINERAL NAME
b-tricalcium phosphate
Whitlockite
MINERAL NAME
Carbonate apatite phosphate
Dahllite
MINERAL NAME
Calcium carbonate
Aragonite
MINERAL NAME
Uric acid/uric acid dihydrate
Uricite
MINERAL NAME
Magnesium ammonium phosphate
Struvite
MINERAL NAME
Magnesium acid phosphate trihydrate
Newberyite
MINERAL NAME
Magnesium ammonium phosphate monohydrate
Dittmarite
Radiopaque stones
Calcium oxalate dihydrate
Calcium oxalate monohydrate
Calcium phosphates
Poor radiopacity
Magnesium ammonium phosphate
Apatite
Cystine
Radiolucent stones
Uric acid Ammonium urate Xanthine 2,8-Dihydroxyadenine Drug-stones
Repeat stone analysis in patients presenting with:
Recurrent stones despite drug therapy
Early recurrence after complete stone clearance
Late recurrence after a long stone-free period because stone composition may change
Pregnant women: first and second line imaging
1st: Ultrasound
2nd: MRI
Last option: low-dose CT
Children: diagnosis recommendations in children
Complete metabolic evaluation based on stone alaysis
Collect stone material to classify stone type
First-line imaging: ultrasound (kidney, fluid-filled bladder, ureter)
KUB x-ray or low dose non-contrast CT if ultrasound will not provide information
Pain relief: first drug of choice
NSAIDs and paracetamol: ex. metamizoledipyrone.
Pain relief: second drug of choice
Opiates: hydromorphine, pentazocine, or tramadol (NOT pethidine)
Pain relief: when to offer renal decompression or URS stone removal
In case of analgesic refractory colic pain
Two options for urgent decompression of obstructed collecting systems:
Indwelling ureteral stent placement
Percutaneous nephrostomy tube placement