Flashcards in Renal stones Deck (9)
what are the different stones?
- RENAL stones: cause excruciating loin pain
- URETERIC stones: cause ureteric colic, radiates from loin to groin
- BLADDER or URETHRAL stones: cause pain on micurtition and interrupt urine flow
how can they be classified?
- size: <5, 5-20, 20, staghorn
- location: renal (calyceal, plevic, diverticular)
- Xray characteristic: radiolucent or opaque
- stone composition: Ca, Ox, CaP, uric acid, cysteine, indinavir
what is ureteric colic described as?
- loin pain
- soft abdomen
- microscopic haematuria (in 85%)
what are the causes of ureteric colic?
- blood clot passing
- BPH, CaP
what are the other DDx?
- testicular torsion
- perforated PU
- ruptured ectopic pregnancy
- ovarian torsion
what is the management of colic?
- basic investigations (FBC, UE, Ca, urine dipstick, bhCG)
- KUB, CT KUB
- wait for stone to pass
what do you do medically if the stone is too large?
- alkalinise or acidify urine
- prevent UTI
what do you do surgically if the stone is too large?
- ESWL (lithiotripsy = shock wave treatment)
- uterorenoscopy with laser (much more invasive as it involves inserting rigid scope into ureter or kidney)
- PCNL (percutaneous nephrolithiotomy = laproscopic removal of stpne woth forceps, invasive)