Urolithiasis and urological pain

Question 1

What is urolithiasis ?

Answer 1

renal and ureteric stones

Question 2

When are patients most susceptible to stone formation ?

Answer 2

decrease in urine volume or an excess of stone forming substances in the urine

Question 3

what are the risk factors associated with stone formation ?

Answer 3

dehydration, change in urine PH, males aged between 40-60 years, positive family history, obesity, urinary anatomical abnormalities, excessive dietary intake of oxalate, rate, sodium, animal protein. Vitamin D and calcium, also diuretics.

Question 4

What are the lifestyle advice for people with renal stones ?

Answer 4

• drink 2.5 to 3 l of water a day with addition of fresh lemon juice
• avoid carbonated drinks
• maintain normal daily calcium intake: 700 to 1.200 mg per day
• salt intake of no more than 6g a day

Question 5

Patients who have recurrent calcium stones, what should you tell them to avoid ?

Answer 5

avoid excessive intake of oxalate rich products: rhubarb, spinach, cocoa, tea, nuts, soy products, strawberries, wheat bran

Question 6

Patients who have recurrent uric acid stones, what should they avoid ?

Answer 6

avoid urate rich products such as liver, kidney, calf thymus, poultry skin, herring with skin, sardines and anchovies

Question 7

What painkillers are first line for people with suspected renal colic or renal and ureteric stones ?

Answer 7

NSAIDs, if contraindicated then consider IV paracetamol or opioids

Question 8

What can be recommended for urethral pain or to relieve the discomfort of catheterisation ?

Answer 8

Lidocaine gel