Urolithiasis Flashcards
Which gender is most likely to get urolithiasis
younger males
What is the most common cause of urological emergency admission
Renal colic
What is renal colic
Pain that may occur when a stone becomes lodged in your urinary tract
What are symptoms and signs of urolithiasis
Renal pain - back flank and groin
Ureteric colic
Dysuria
Haematuria
Testicular or vulval pain
UTI
tender loin
Pyrexia
What are the most common types of stone
Calcium oxalate is the most common type of mineral in the stones
calcium phosphate is also common
What is ureteric colic
Pain radiating to the groin
What are investigations done for urolithiasis
Blood tests - full blood count, U&E, creatinine, calcium, albumin, urate, parathormone
urine analysis
Radiological investigations - KUB, ultrasound
What cannot be seen in ultrasound for urinary system
Ureters as they are very retroperitoneal so have many structures in front of them
Why can stones be seen on
X-ray
Because they are made up of calcium usually
Why is removal of kidney stones such a delicate procedure
The kidney is well vascularised so the blood vessels have to be avoided
What are the indications for surgical treatment of urolithiasis
obstruction, recurrent gross haematuria , recurrent pain and infection , progressive decrease in GFR and what their occupation is
What surgery technique is most common for removal of stones
Endoscopic surgery
What are the advantages and disadvantages of open surgery for renal stone removal
advantage - single procedure with low recurrence rate
Disadvantage - large scar with long hospital stay and a long recovery
What are indications for open surgery
Non functioning infected kidney with large stones which needs a nephrectomy
What is a pyelolithotomy
Removal of a renal stone from the renal pelvis
What are staghorn stones
Formed by infection of the kidneys and forms in the shape of the collecting system
What is PCNL
Percutaneous nephrolithotomy
What are the indications for PCNL
Large stone burden
PUJ stenosis
Morbid obesity
Describe Percutaneous nephrolithotomy
Catheter is passed up into the kidney collecting system
A contrast is used, and the collecting system is dilate enough to break up the stone
What guides a percutaneous access
Ultrasound or xray
What are the contraindications for PCNL
uncorrected coagulopathy
Active uti
Obesity or an unsuitable body for X-ray tables
What are the complications of PCNL
pseudoaneurysm or AV fistula
Pelvic or ureteral tear
PUJ stricture
Injury to adjacent organs - bowel and lungs
Could cause infection like sepsis
What does ESWL stand for
Extracorporeal shock wave lithotripsy
What happens in ESWL
The stones are too large to pass through the renal pelvis
The ESWL shock waves the stones which crushes them allowing the smaller pieces to pass out into the urine
X-ray or ultrasound is used to guide where to place the shockwaves
