Presentation
Presentation Abdominal or flank pain occurs in approximately half of the children presenting with urolithiasis, but the classical description of excruciating loin pain associated with the passage of the stone is uncommon. [adc.bmj.com]
Credit: remik44992/Shutterstock.com Patients may present with nausea, vomiting, blood in the urine and pain in the back, flank and lower abdomen. [news-medical.net]
The ipsilateral ureter presented normal caliber in the proximal portion and it was slightly increased in the distal, with absent calculi. [scielo.br]
Epidemiology[2] Renal stones are common, being present at some time in one in ten of the population, although a significant proportion will remain asymptomatic. [patient.info]
Parathyroid hormone (PTH): May be increased if kidney failure present. (PTH stimulates reabsorption of calcium from bones, increasing circulating serum and urine calcium levels.) [nurseslabs.com]
Gastrointestinal
- Nausea
It’s common for people with a kidney stone to have nausea and vomiting (8). These symptoms happen because of shared nerve connections between the kidneys and GI tract (9). [healthline.com]
Nausea and vomiting are common. Factors predisposing to kidney stones include recent reduction in fluid intake, increased exercise with dehydration, medications that cause hyperuricemia (high uric acid) and a history of gout. [medicinenet.com]
Seek immediate medical attention if you experience: Pain so severe that you can't sit still or find a comfortable position Pain accompanied by nausea and vomiting Pain accompanied by fever and chills Blood in your urine Difficulty passing urine Causes [mayoclinic.org]
Hematuria, pyuria, dysuria, anuria, frequency of urination, nausea and vomiting may be present. The presence of a palpable object may be noted. [pubs.rsna.org]
- Abdominal Pain
Other considerations in the general evaluation of acute abdominal pain are discussed elsewhere (see Acute Abdominal Pain: Evaluation). Patients suspected of having a calculus causing colic require urinalysis and usually an imaging study. [msdmanuals.com]
Signs and Symptoms of Bladder Calculi Childhood Symptoms in Endemic Bladder Stones: Abdominal pain Interrupted urine flow Dysuria, alguria, frequency Need to manipulate the penis Symptoms due to Secondary Bladder Stones: Recurrent urinary tract infections [urology-textbook.com]
[…] and tenderness Abdominal pain Small renal calculi, nonurologic etiology (gastrointestinal origin) Flank pain (sharp, extreme pain with sudden onset) Urinary calculi, musculoskeletal spasm Flank tenderness Urinary calculi, musculoskeletal inflammation [aafp.org]
Nausea, Vomiting, Urinary frequency/urgency, Haematuria (blood in the urine), Abdominal pain, Dysuria (painful urination), Nocturia (excessive at night), Urinary hesitancy, Fever, Chills and Abnormal urine color or smell. [healthengine.com.au]
In addition, helical CT is better than US or IVU in detecting other causes of abdominal pain. [emedicine.medscape.com]
Urogenital
- Kidney Failure
[…] stones) Can cause hydronephrosis (swollen kidneys) and kidney failure Can predispose to pyelonephritis (kidney infections) Can progress to urolithiasis Urolithiasis (urinary bladder stones) Can progress to bladder outlet obstruction Cholelithiasis (gallstones [en.wikipedia.org]
- Oliguria
Observe for signs of urinary tract infection (chills, fever, frequency, and hesitancy) and obstruction (frequent urination of small amounts, oliguria, or anuria). Observe urine for blood; strain for stones or gravel. [nurseslabs.com]
- Retrograde Ejaculation
When younger men undergo prostate surgery, the postoperative incidence of impotence and retrograde ejaculation is increased. Therefore, prevention of prostatic calculi has gained increasing attention. [alliedacademies.org]
- Chronic Pelvic Pain Syndrome
Anti-nanobacterial therapy for men with chronic prostatitis/chronic pelvic pain syndrome and prostatic stones: preliminary experience. J Urol 2005; 173: 474-477. [alliedacademies.org]
Workup
[…] stone removal or external shockwave lithotripsy - both of which are expensive and may result in renal hemorrhage, fibrosis or hypertension, reduced renal function, or injury of renal tissue Improving workflow by avoiding lengthy and painful metabolic workup [siemens-healthineers.com]
Diagnosis[edit] Diagnostic workup varies by the stone type, but in general: Clinical history and physical examination Imaging studies Some stone types (mainly those with substantial calcium content) can be detected on X-ray and CT scan Many stone types [en.wikipedia.org]
Treatment
Recent Advances in Aetiology, Stone Structure and Treatment International Symposium on Renal Stone Research, Madrid, September 1972: Proceedings. [karger.com]
Although new ureteroscopes and lithotripters have been developed, the best treatment for impacted ureteral stones remains controversial. [scielo.br]
If treatment is required, the most effective method should be discussed with the specialist. [casa.gov.au]
Treatment of Urinary Bladder Stones The majority of bladder stones can be treated endoscopically. Treatment options are influenced by the anatomy, etiology, concomitant diseases and stone size. [urology-textbook.com]
Prognosis
Ureteric Calculi Ureteric Calculi Prognosis [news-medical.net]
Provide information about disease process/prognosis and treatment needs. [nurseslabs.com]
Treatment and prognosis Most drug-induced calculi can be treated conservatively, usually maintaining a high urine output with an increased fluid intake. [radiopaedia.org]
[…] acid stones Struvite stones (triple phosphate stones/magnesium ammonium phosphate stones) Less common stones Clinical features Diagnostics Differential diagnoses Treatment Approach considerations Medical therapy Urological intervention Complications Prognosis [amboss.com]
Etiology
The etiological factors for these different types of stones vary. [news-medical.net]
Less common stones Calcium phosphate stones Etiology Hyperparathyroidism Type 1 renal tubular acidosis Specific preventive measures Thiazide diuretics Urine acidification Cystine stones Etiology: hereditary defect in renal tubular absorption of dibasic [amboss.com]
Urethrovaginal fistula is the main cause of vaginal calculi and the other etiologies are extremely rare (2). [numonthly.com]
Crystallographic analysis of retrieved calculus remnants can help identify the underlying etiology and may obviate a complete metabolic evaluation. [aafp.org]
Clinical history and physical examination Imaging studies Some stone types (mainly those with substantial calcium content) can be detected on X-ray and CT scan Many stone types can be detected by ultrasound Factors contributing to stone formation (as in #Etiology [en.wikipedia.org]
Epidemiology
The purpose of this review is to portray the current epidemiology and cause of renal stones in children, to provide a framework for appropriate clinical evaluation on an individual basis, and a guidance regarding treatment and prevention for the significant [journals.lww.com]
Epidemiology Sex: ♂ > ♀ Peak incidence: 30–60 years Risk factors Low fluid intake, dehydration Personal or family history See “Classification” below. References:[1][2][3][4] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]
Trends in urological stone disease.BJU Int. 2012 Apr;109(7):1082-7 Links: epidemiology aetiology pathogenesis sites of stone impaction clinical features differential diagnosis investigations management prevention of urinary tract stones [gpnotebook.co.uk]
Links: epidemiology aetiology pathogenesis sites of stone impaction clinical features differential diagnosis investigations management prevention of urinary tract stones referral criteria from primary care - renal stones [gpnotebook.com]
Epidemiology and Causes of Bladder Stones Endemic bladder stones: Malnutrition in developing countries causes bladder stones in children without the presence of bladder emptying disorders. Affected areas are North Africa, the Middle and Far East. [urology-textbook.com]
Pathophysiology
Pathophysiology: Renal stones are formed when the urine is not able to dissolve the minerals that comes along with the excretion of the body. Those minerals crystallizes and solidifies until it may block the passageway. [nursingcrib.com]
PATHOPHYSIOLOGY November5,2017 31 32. November5,2017 32 33. November5,2017 33 34. [slideshare.net]
Uric acid is the second most common mineral type, but an in vitro study showed uric acid stones and crystals can promote the formation of calcium oxalate stones.[1] Pathophysiology and symptoms[edit] Stones can cause disease by several mechanisms: Irritation [en.wikipedia.org]
Prevention
Assess patient’s knowledge about renal stones and measures to prevent recurrence. [nurseslabs.com]
The early identification of modifiable risk factors and other abnormalities is essential, to prevent related morbidity, the onset of chronic kidney disease, and the associated increased risk of developing other diseases. [journals.lww.com]
Your doctor may prescribe medications to help prevent the formation of calcium and uric acid stones. If you’ve had a kidney stone or you’re at risk for a kidney stone, speak with your doctor and discuss the best methods of prevention. [healthline.com]