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Calculi

Stones


Presentation

  • Usual presentation of renal/ureteric stones is as an acute episode with severe pain (1) although some stones are picked up incidentally during imaging or may present as a history of infection the initial diagnosis is made by taking a clinical history[gpnotebook.co.uk]
  • A history of a specific disease with relevant medication history is also often present, e.g. HIV/AIDS on protease inhibitors.[radiopaedia.org]
  • If infected, patients may also present with fever, chills, or other systemic signs of infection.[ncbi.nlm.nih.gov]
Family History of Gout
  • A family history of gout or renal calculi would also influence the decision to investigate. Investigations The first 3 key investigations are urine microscopy and culture, assessment of renal function and imaging of the urinary tract.[nps.org.au]
Pertussis
  • […] murium, C equi ) Mycobacterium rhodochrous group Micrococcus varians Bacillus species Clostridium tetani Peptococcus asaccharolyticus Gram-negative bacteria that cause struvite stones are as follows: Bacteroides corrodens Helicobacter pylori Bordetella pertussis[emedicine.medscape.com]
Heart Disease
  • CONTINUE SCROLLING OR CLICK HERE FOR RELATED ARTICLE Reviewed on 12/27/2018 SLIDESHOW Heart Disease: Causes of a Heart Attack See Slideshow[medicinenet.com]
Withdrawn
  • […] sulfonamide class e.g. sulfadiazine aminopenicillin class e.g. ampicillin, amoxicillin ceftriaxone quinolone class e.g. ciprofloxacin nitrofurantoin protease inhibitors: especially indinavir, atazanavir efavirenz (antiretroviral) glafenine (NSAID - withdrawn[radiopaedia.org]
Chronic Pelvic Pain Syndrome
  • Patients with prostatic calculi usually have no symptoms, but large calculi may result in uroschesis, prostatitis, and chronic pelvic pain syndrome [ 6, 7 ].[alliedacademies.org]
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]

Workup

  • 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]
Staphylococcus Aureus
  • Etiology Gram-positive bacteria that cause struvite stones are as follows: Staphylococcus aureus Staphylococcus epidermidis Corynebacterium species (ie, C ulcerans, C renale, C ovis, C hofmannii, C murium, C equi ) Mycobacterium rhodochrous group Micrococcus[emedicine.medscape.com]
Gram-Positive Bacteria
  • Etiology Gram-positive bacteria that cause struvite stones are as follows: Staphylococcus aureus Staphylococcus epidermidis Corynebacterium species (ie, C ulcerans, C renale, C ovis, C hofmannii, C murium, C equi ) Mycobacterium rhodochrous group Micrococcus[emedicine.medscape.com]

Treatment

  • 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]
  • 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]
  • Future research is desirable, with the aim to strengthen personalized conservative management of pediatric nephrolithiasis as first-line treatment. Department of Urology, Cottolengo Hospital, Torino, Italy Correspondence to Cesare M.[journals.lww.com]
  • Patients on treatment may still make stones, albeit fewer than otherwise.[ncbi.nlm.nih.gov]

Prognosis

  • Treatment and prognosis Most drug-induced calculi can be treated conservatively, usually maintaining a high urine output with an increased fluid intake.[radiopaedia.org]
  • These malignancies carry a very poor prognosis, with a 5-year survival rate of less than 10%. [5] Priestley and Dunn reported a 41% 5-year survival rate in patients with untreated unilateral struvite stones. [6] These data underscore the importance of[emedicine.medscape.com]
  • Prognosis Approximately 80-85% of stones pass spontaneously. Approximately 20% of patients require hospital admission because of unrelenting pain, inability to retain enteral fluids, proximal UTI, or inability to pass the stone.[emedicine.medscape.com]

Etiology

  • It is apparent that the chemical substances which go to make up urinary calculi vary under different conditions, and are dependent in part on the etiologic factor. During the last decade, bacteria[jamanetwork.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]
  • 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]
  • 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]
  • Urolithiasis in the pediatric population - current opinion on epidemiology, patophysiology, diagnostic evaluation and treatment. Dev Period Med. 2018; 22 (2):201-208. [ PubMed : 30056408 ] 7.[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • 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:[en.wikipedia.org]

Prevention

  • 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]
  • Many patients are subjected to frequent surgical procedures before appropriate preventive measures are initiated.[nps.org.au]
  • Renal tubular acidosis), familial and early onset renal calculi Recurrent episodes of renal colic or calculi despite preventative measures Evidence of parenchymal calcification or Randall’s plaques.[casa.gov.au]
  • Therefore, prevention of prostatic calculi has gained increasing attention.[alliedacademies.org]

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