A shock wave is generated by a source external to the patient that propagates through the body before being focused on a kidney stone. Improved fibreoptics and deflectability and the reduced size of ureteroscopes have expanded the use of ureteroscopy for stones in the upper urinary tract. The technique enables stones to be retrieved for analysis, and all stone material can be removed so that the patient does not have to pass any fragments, as is common with shock wave lithotripsy and ureteroscopy. Eur Urol ; In human and animal models it can cause acute renal injury. Initial evaluation of the patient with urolithiasis should include a complete medical history and physical examination. Journal List BMJ v.

References] Click here to view. The patient was successfully treated with percutaneous nephrolithotomy. UC is usually asymptomatic; therefore, it is most frequently detected incidentally. Additionally, articles published within Cureus should not be deemed a suitable substitute for the advice of a qualified health care professional. Please review our privacy policy. JEL has been a consultant and advisor for Lumenis and Olympus; meeting participant and lecturer for Karl Storz; and an investigator and lecturer for Boston Scientific. Miner Electrolyte Metab ;

A retrospective study showed that ureteroscopy is useful when lithotripsy fails; when complex or lower pole renal calculi are present 14 ; or when patient factors such as pregnancy, coagulopathy, or morbid obesity preclude lithotripsy.

UC is usually asymptomatic; therefore, it is most frequently detected incidentally. Radiographically, a differential diagnosis of multiple transitional cell tumors, ureteral pseudodiverticula, non-opaque calculi, polyps, papillary tumors, tuberculosis, iatrogenic gas bubbles, gas-forming microorganisms, and submucosal hemorrhage can be considered with an appropriate clinical correlation [ 4 ].


J Clin Imaging Sci. Journal List BMJ v. If urgent intervention is not needed see box 2the patient and clinician must decide whether to intervene or proceed with expectant management. Ureteroscopy involves retrograde visualisation of the collecting system using a rigid, semi-rigid, or flexible endoscope.

Management of kidney stones

A more detailed metabolic evaluation is best performed after the acute stone event has resolved. Fig 2 Complex left renal calculus. Articles from Cureus are provided here courtesy of Cureus Inc. Renal calculi The characteristics of the stufy size, number, location, and compositionrenal anatomy, and clinical factors are all considered when selecting a treatment approach for renal calculi. The management of lower pole calyceal calculi remains controversial.

Royal Infirmary of Edinburgh Renal Unit http: Urol Clin North Am ; It usually occurs in middle-aged to elderly females following chronic urolithiasis uroljthiasis recurring urinary tract infections.

Ureteritis Cystica: An Unusual Presentation in an Otherwise Healthy Female

Finally, microscopic urinalysis may identify crystals, such as the classic hexagonal crystals seen in cystinuria. Axial CT image showing urolithiaasis left ureter white arrow and moderate hydronephrosis of the left kidney red arrow CT: Volume, pH, calcium, oxalate, citrate, uric acid, phosphate, sodium, potassium, magnesium, ammonium, chloride, sulfate, and creatinine.

urolithiasis case study scribd

For the purposes of selecting treatment, ureteral calculi can be udolithiasis into categories on the basis of location—proximal or distal—with the point of division being the narrow part of the ureter over the iliac vessels. While parenteral narcotics have traditionally been prescribed for acute renal colic, 8 non-steroidal anti-inflammatory drugs such as ketorolac and diclofenac are effective in relieving pain by inhibiting prostaglandin mediated pain pathways and decreasing ureteral contractility.


Open surgery was the mainstay of treatment for urolithiasis, but it has now been supplanted by less invasive treatments. Pyelitis, ureteritis and cystitis cystica; pp. J Urol ; 3 Pt 2: These blockers inhibit basal ureteral tone and peristaltic frequency and decrease the intensity of ureteral contractions.

urolithiasis case study scribd

JEL reviewed, revised, and approved the final paper and will serve as guarantor. Cochrane Database Syst Rev ; 1: Other treatment modalities include ureteral dilation or mechanical disruption of cysts and ureteral catheterization.

Ureteritis Cystica: An Unusual Presentation in an Otherwise Healthy Female

Stone fragments are removed using suction, graspers, or basket extraction. Alexander Muacevic and John R Adler.

Box 5 outlines the components of a standard metabolic evaluation. Please review our privacy policy. Strategies for improved shock wave lithotripsy. The patient was successfully treated with percutaneous nephrolithotomy. Tamsulosin and corticosteroid was the most efficacious combination—stones were passed more quickly and the need for analgesics was reduced. Diabetes mellitus and hypertension associated with shock wave lithotripsy of renal and proximal cse stones at 19 years of follow up.