Urolithiasis Flashcards
what is urolithiasis?
kidney stone disease
solid price of material occurring in the urinary tract
What are colics usually made of?
calcium oxalate
calcium oxalate + phosphate
‘triple phosphate’
symptoms and signs of kidney stone
renal pain
ureteric colic radiates pain to groin
dysuria/ haematuria
urinary infection
loin tenderness
pyrexia
investigations in kidney stone disease include:
not imaging
blood tests: FBC, U+Es, creatinine
albumin, calcium, urate
parathromone
urinalysis and culture
24 hour urine collections
imaging investigations in kidney stone disease
ultrasound
CT scan
IVU (intravenous urogram)
IVU
intravenous urogram
PCNL
Percutaneous Nephrolithotomy
indications that the patient with kidney stone disease needs open surgery
obstruction
recurrent gross haematuria
recurrent pain and infection
loss of kidney function
open surgery might be the treatment when what two other procedures cannot be performed?
PCNL
ESWL
indications for PCNL
Large stone burden
Associated PUJ stenosis
Infundibular stricture
ESWL resistant stones
obesity
What is Percutaneous nephrolithotomy?
removing stones through a small puncture wound in the skin
wire is guided into the pelvis
ESWL
extracorporeal shock wave lithotripsy
What is extracorporeal shock wave lithotripsy?
ultrasound shock waves crush stones so they can pass through the urine as smaller pieces
what is the first line of treatment for kidney stones?
ESWL
how do we treat ureteric stones?
when ESWL has failed
ureteroscopy
