Urinary tract calculi Flashcards
Urinary tract calculi?
Crystal deposition within the urinary tract, also known as nephrolithiasis.
Urinary tract calculi, types of stones?
calcium oxalte, struvite, urate, cysteine
Urinary tract calculi aetiology?
many are idiopathic,
metabolic causes (hypercalciuria, hyperuricaemia, hypercystinuria, hyperuricaemia),
infection (hyperuricaemia),
drugs (indavir).
Urinary tract calculi risk factors?
low fluid intake, structural urinary tract abnormalities
Urinary tract calculi epidemiology?
3% of population,
3x more common in males,
20-50yrs,
bladder stones common in developing countries, upper urinary tract stones in HICs.
Urinary tract calculi symptoms?
Often asymptomatic, severe loin to groin pain, nausea and vomiting, urinary urgency, frequency or retention, haematuria
Urinary tract calculi signs?
lower abdo tenderness, no signs of peritonitis.
Leaking AAA is main differential to consider in older men.
Urinary tract calculi investigations?
FBC (WCC in infection), U&Es to check renal function, calcium, urate, phosphate, Urine dipstick,
XRKUB as 80% of kidney stones are radio-opaque,
intravenous urography allows visualisation of kidneys and ureters,
USS may show hydronephrosis and hydroureter.
Urinary tract calculi management?
in acute presentation; analgesia, bed rest, fluid replacement, urine collection to try and retrieve any passed stone (<5mm will pass spontaneously),
an obstructed, infected kidney is an emergency.
Urinary tract calculi removal of stone?
urethroscopy (scope passed into bladder and up ureter to visualise and collect stone, extracorporeal shock-wave)
lithotripsy (non invasive shockwave focused on calculus to break it into fragments, percutaneous nephrolithotomy (for large stones)
Urinary tract calculi complications?
of stones (infection ie pyelonephritis, septicaemia, urinary retention), of uteroscopy (perforation, false passage),
of lithotripsy (pain, haematuria).
