Urolithiasis 2

Question 1

Which tx?

• Indications: failure of / contraindications to other modalities
  
  • trial of passage
  • dissolution
  • ESWL
  • Ureteroscopy w/ stone manipulation
  • PCNL

Answer 1

Open or Laparoscopic Surgery

(not common, is usually last resort)

Question 2

4 types of Open / Laparoscopic Surgery

Answer 2

• Cystolithotomy (large stone burden, other concomitant surgery)
• Pyelolithotomy
• Ureterolithotomy
• Anatrophic nephrolithotomy (Brodel’s avascular plane)

Question 3

5 components of metabolic eval to prevent future stones

Answer 3

• H&P
• UA
• Stone analysis
• Serum labs (electrolytes, uric acid, Ca, phosphate, alkaline phosphatase, creatinine)
• 24 hour urine collection