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.