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]
For a quick overview of the capabilities of CalculiX the results of an investigation of a small jet engine are presented. The jet engine was build around a turbo-charger rotor in the early 90’s by Andreas Funke and Klaus Wittig. [arek.pajak.info.pl]
Entire Body System
- Pain
Instruct patient to report decreased urine volume, bloody or cloudy urine, fever, and pain. Instruct patient to report any increase in pain. [nurseslabs.com]
Whereas the pain of biliary or intestinal colic is intermittent, the pain of renal colic is more constant but there are often periods of relief or just a dull ache before it returns. The pain may change as the stone moves. [patient.info]
The pressure activates nerve fibers that transmit pain signals to the brain. Kidney stone pain often starts suddenly. As the stone moves, the pain changes location and intensity. [healthline.com]
Endoscopic kidney stone removal has a much faster recovery time and is minimally invasive, which means less pain and a quicker recovery. [advuro.com]
Pain-killers may be needed to control renal colic (pain associated with the passage of stones). Severe pain may require strong pain-killers such as morphine or pethidine. [healthengine.com.au]
- Chills
Chills or shivering often occur along with the fever. Kidney stones are hard collections of salt and minerals that form in your kidneys and can travel to other parts of your urinary system. [healthline.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]
Infection Clinical Manifestations: acute, sharp, intermittent pain (ureteral colic) dull, tender ache in the flank nausea and vomiting accompanying severe pain fever and chills hematuria abdominal distention pyuria Diagnostic Evaluation: Kidneys, ureters [nursingcrib.com]
Symptoms can include: Blood in the urine (hematuria) Increased frequency of urination (urinary urgency) Nausea and vomiting Pain during urination (stinging, burning) Tenderness in the abdomen and kidney region Urinary tract infection ( UTI ; fever, chills [advuro.com]
Other symptoms include restlessness, blood in the urine, nausea, vomiting, discolored urine, bad-smelling urine, chills, fever, difficulty urinating, or frequently feeling the urge to urinate but only producing a small amount. [study.com]
- Severe Pain
Pain in the lower abdomen. Sweating. Brown, Red and Pink Urine. Foul smelling urine. Cloudy Urine. Experiencing pain during urination. Vomiting and Nausea. Restlessness. Severe pain in the ribs. Urinary Urgency. Discharge of blood in the urine. [byjus.com]
When symptoms are present, they usually include severe pain in the lower abdomen and back, difficult or frequent urination, blood in the urine, and fever. Increased hydration is the usual way to prevent bladder stone formation. [luriechildrens.org]
This is common with any severe pain. There may be severe pain in the testis but the testis should not be tender. Blood pressure may be low. [patient.info]
Aeromedical Implications Effect of aviation on condition Low fluid intake, especially in hot conditions Effect of condition on aviation Overt incapacitation from severe pain and vomiting Distraction due to treatment & symptoms High recurrence rate of [casa.gov.au]
Infection Clinical Manifestations: acute, sharp, intermittent pain (ureteral colic) dull, tender ache in the flank nausea and vomiting accompanying severe pain fever and chills hematuria abdominal distention pyuria Diagnostic Evaluation: Kidneys, ureters [nursingcrib.com]
- Surgical Procedure
Surgical procedure for vesical calculi greatly antedates that for kidney and ureteral calculi. Ultzman 1 quotes Olympios of Athens as having shown that lithotrity was done in the ninth century. [jamanetwork.com]
Bladder stones are treated using a surgical procedure called a cystolithotomy. [luriechildrens.org]
Stones 4 mm and smaller (less than 1/4 inch in diameter) pass without intervention in 90% of cases; those 5–7 mm do so in 50% of cases; and those larger than 7 mm rarely pass without a surgical procedure. [advuro.com]
procedure to document location of attached stones and condition of calyces and papilla. [clinicaltrials.gov]
- Rigor
Preventive lifestyle measures are often advised such as drinking sufficient amounts of water and milk although the effect of many dietary interventions has not been rigorously studied. [southtees.nhs.uk]
However, there has been no in-vivo, rigorous documentation of this "attached stone" relationship. [clinicaltrials.gov]
Other symptoms which may be present include: Rigors and fever. Dysuria. Haematuria. Urinary retention. Nausea and vomiting. Examination The patient with colic of any sort writhes around in agony. [patient.info]
Gastrointestinal
- Vomiting
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]
Vomiting usually resolves as pain decreases, but persistent vomiting can be treated with an antiemetic (eg, ondansetron 10 mg IV). [msdmanuals.com]
Assess for associated symptoms, including nausea, vomiting, diarrhea, and abdominal distention. [nurseslabs.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]
- 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]
Kidney stone symptoms include: extreme pain (renal colic or ureteral colic), nausea/vomiting, urinary retention, infection. Treatment for renal stones include extracorporeal shock wave lithrotripsy (ESWL). [youtube.com]
- 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]
The initial use of IV contrast for CT scans in patients with abdominal pain is not recommended. [ncbi.nlm.nih.gov]
Cardiovascular
- Hypertension
Furthermore, the median systolic and diastolic blood pressures were significantly higher in the hypertensive group than that in the nonhypertensive group. [hindawi.com]
[…] reliable differentiation of uric acid versus non-uric acid stones can avoid invasive interventional urinary procedures for stone removal or external shockwave lithotripsy - both of which are expensive and may result in renal hemorrhage, fibrosis or hypertension [siemens-healthineers.com]
Hypertension. Gout. Hyperparathyroidism. Immobilisation. Relative dehydration. Metabolic disorders which increase excretion of solutes - eg, chronic metabolic acidosis, hypercalciuria, hyperuricosuria. Deficiency of citrate in the urine. [patient.info]
The doses may be higher than those given for hypertension, and hydrochlorothiazide 50 mg a day is commonly used. [nps.org.au]
[…] ureteral stone Generally unremarkable abdominal evaluation: Possibly hypoactive bowel sounds; usually, absence of peritoneal signs; possibly, painful testicles but normal-appearing Constant body positional movements (eg, writhing, pacing) Tachycardia Hypertension [emedicine.medscape.com]
Skin
- Sweating
Sweating. Brown, Red and Pink Urine. Foul smelling urine. Cloudy Urine. Experiencing pain during urination. Vomiting and Nausea. Restlessness. Severe pain in the ribs. Urinary Urgency. Discharge of blood in the urine. [byjus.com]
Calculi in the skin, such as in sweat glands, are not common but occasionally occur. Calculi are usually asymptomatic, and large calculi may have required many years to grow to their large size. [en.wikipedia.org]
Musculoskeletal
- Muscle Spasm
The resulting obstruction causes dilation or stretching of the upper ureter and renal pelvis as well as muscle spasm of the ureter, trying to move the stone. [southtees.nhs.uk]
Muscle spasm, increased proximal peristalsis, local inflammation, irritation, and edema at the site of obstruction may contribute to the development of pain through chemoreceptor activation and stretching of submucosal free nerve endings. [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]
- Dysuria
Dysuria, alguria, frequency Interrupted urinary flow or urinary retention The majority of bladder stones cause no additional problems in addition to the underlying bladder disorder. [urology-textbook.com]
Ureteric stents cause significant symptoms (frequency, dysuria, haematuria & loin pain) in 80% of patients. Antibiotic treatment in these patients has no effect on stent symptoms but severe symptoms may be helped by NSAIDs. [camurology.org.uk]
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]
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]
- 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]
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]
If treatment is required, the most effective method should be discussed with the specialist. [casa.gov.au]
Although new ureteroscopes and lithotripters have been developed, the best treatment for impacted ureteral stones remains controversial. [scielo.br]
The use of a mobile machine may affect options for emergency treatment, but may also add to waiting times for non-emergency treatment URS for renal and ureteric stones is increasing (there has been a 49% increase from 12,062 treatments in 2009/10, to [gpnotebook.co.uk]
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]
From experimental and clinical observation, it appears evident that no one etiologic agent is entirely responsible for the formation of all kidney stones. [jamanetwork.com]
Urethrovaginal fistula is the main cause of vaginal calculi and the other etiologies are extremely rare (2). [numonthly.com]
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]