Kidney Stones

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Kidney Stones


Classification
Types
Constituents


Seen In
Calcium Based Stones
Calcium Oxalate/ Calcium Phosphate
Radiopaque
Most Common Kidney Stone
Hypercalcemia, Hypercalciuria And Hyperoxaluria
Uric Acid Stones
Uric Acid
Radiolucent
Most Common Radiolucent Kidney Stone
Gout, Lesch-Nyhan Syndrome & Myeloproliferative Disorder
Struvite Stones
Magnesium, Ammonium & Phosphate
Radiopaque
Staghorn Calculi
Develop In Alkaline Urine associated with Urea-splitting organism (e.g., Proteus, Klebsiella)
Cystine Stone
Cystine
Intermediate Radiolucency
Hexagonal Crystals
Cystinuria

kidney-stone-renal-stone


Clinical Presentation
Clinical Presentation
Most of the patients are Asymptomatic
Most common symptom is Renal or Ureteric colic
Costovertebral angle pain or Flank pain which can radiate to the Scrotum or Labia
Hematuria

Location of Stones
Pain radiates to
Pelvis/ Upper third of Ureter
Testis
Middle third or Ureter
Iliac fossa
Lower third of Ureter
Inner aspect of Thigh, Scrotum or Perineum

Imaging
Imaging
A Plain X-Ray KUB may reveal the Radiopaque stones.
Investigation of choice to diagnose Acute Ureteric colic is NCCT.

Treatment
Conservative management
1.Hydration (Plenty of fluids)  to increase Urine output
2.Analgesia
Indication of Conservative management
Stone Size 5mm
Non-Dilated pelvicalyceal system
Stone In Distal third Of Ureter
Downward movement of stone on Repeated scan

Interventions For Renal Stones
Interventions For Renal Stones
1.ESWL (Extracorporeal Shock Wave Lithotripsy)
Curative in 85 % cases
Useful for stones up to 2cm
Contraindications: Pregnancy, Bleeding disorder
2.PSNL (Percutaneous Nephrolithotomy)
Indicated in stones  > 2cm, ESWL Failure
3.URS (Ureterorenoscopy)
Ureteric stones
4.LSS (Laparoscopic Stone Surgery)

5.OSS (Open Stone Surgery)


Prevention
Prevention of Stones
1.Maintenance of high urine output (2 to 3 L/d) With Oral Hydration
2.Low-Salt diet (<2 g/d)

To download Urology (Surgery) Handwritten Notes for NEET PG, AIIMS, UPSC CMS & Other PG medical entrance exams CLICK HERE
Contents of this Handwritten Notes
1. Kidney & Ureter
2. Urinary Bladder
3. Prostrate
4. Penis & Urethra
5. Testis & Scrotum


» This post is written for the purpose of solving MCQs. Not for other use



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