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Urinary tract calculi

Background Knowledge ๐Ÿง 

Definition

Solid particles that form in the urinary system. Commonly known as kidney stones or urolithiasis.

Epidemiology

  • Prevalence: 8-15% of the population.
  • More common in males and in hot climates.

Types

  • Calcium: Most common, mainly calcium oxalate.
  • Struvite: Related to infections.
  • Uric acid: Often in gout patients.
  • Cystine: Genetic disorders.

Causes

  • Dehydration.
  • Diet rich in protein, salt, or sugar.
  • Obesity.
  • Certain medical conditions, like hyperparathyroidism.
  • Genetic factors.

Clinical Features ๐ŸŒก๏ธ

Clinical Presentation

  • Renal colic: Severe pain from loin to groin.
  • Haematuria: Blood in the urine.
  • Recurrent UTIs.
  • Nausea or vomiting.

Investigations ๐Ÿงช

Investigations

  • Non-contrast CT KUB: Gold standard for detection.
  • Ultrasound: Good for detecting hydronephrosis.
  • Urine pH and analysis: To detect type of stone.

Management ๐Ÿฅผ

Management

  • Analgesia: NSAIDs preferred.
  • Small stones (< 5 mm): High fluid intake and analgesics, often pass spontaneously.
  • Larger stones or causing obstruction: Extracorporeal shock wave lithotripsy (ESWL) or ureteroscopic removal.
  • Prevention: Adequate hydration, dietary modifications, and certain medications for recurrent formers.

Complications

  • Hydronephrosis: Swelling of a kidney.
  • Recurrent UTIs.
  • Renal impairment.

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