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Urinary tract calculi

Definition
  • Urinary tract calculi: 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 Presentation
  • Renal colic: Severe pain from loin to groin.
  • Hematuria: Blood in the urine.
  • Recurrent UTIs.
  • Nausea or vomiting.
Investigations
  • Non-contrast CT KUB: Gold standard for detection.
  • Ultrasound: Good for detecting hydronephrosis.
  • Urine pH and analysis: To detect type of stone.
Management
  • Analgesia: NSAIDs or opioids.
  • 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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