Nephrolithiasis

Posted by e-Medical PPT
Ureterolithiasis is the condition of having a calculus in the ureter, the tube connecting the kidneys and the bladder.Nephrolithiasis  refers to the condition of having kidney stones. Urolithiasis refers to the condition of having calculi in the urinary tract (which also includes the kidneys), which may form or pass into the urinary bladder.

Symptoms of kidney stones include:
Localization of kidney stone pain
    * Colicky pain: "loin to groin". Often described as "the worst pain ever experienced." This can also occur in the lower back.The pain is elicited by contractions of the ureter in response to the stone, causing severe, crampy pain in the flank or lower back, often radiating to the groin or, in men, to the testes.The pain typically comes in waves, with a typical wave lasting 20 to 60 minutes
    * Nausea/vomiting: embryological link with intestine– stimulates the vomiting center.
    * Hematuria: blood in the urine, due to minor damage to inside wall of kidney, ureter and/or urethra.

There are several types of kidney stones based on the type of crystals of which they consist. The majority are calcium oxalate stones, followed by calcium phosphate stones. More rarely, struvite stones are produced by urea-splitting bacteria in people with urinary tract infections, and people with certain metabolic abnormalities may produce uric acid stones or cystine stones.
The diagnosis of a kidney stone can be confirmed by radiological studies and/or ultrasound examination; urine tests and blood tests are also commonly performed. When a stone causes no symptoms, watchful waiting is a valid option. In other cases, pain control is the first measure, using for example non-steroidal anti-inflammatory drugs or opioids. Using soundwaves, some stones can be shattered into smaller fragments (this is called extracorporeal shock wave lithotripsy). Sometimes a procedure is required, which can be through a tube into the urethra, bladder and ureter (ureteroscopy), or a keyhole or open surgical approach from the kidney's side. Sometimes, a tube may be left in the ureter (a ureteric stent) to prevent the recurrence of pain. Preventive and structive 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.


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