Urolithiasis The
process of forming stones in the kidney, bladder, and/or urethra (urinary
tract).
Kidney stones are a common cause of blood in the urine
and pain in the abdomen, flank, or groin. Kidney stones occur in 1 in 20 people
at some time in their life.
The development of the stones is related to decreased
urine volume or increased excretion of stone-forming components such as
calcium, oxalate, urate, cystine, xanthine, and phosphate. The stones form in
the urine collecting area (the pelvis) of the kidney and may range in size from
tiny to staghorn stones the size of the renal pelvis itself.
The cystine stones (below) compared in size to a
quarter (a U.S. $0.25 coin) were obtained from the kidney of a young woman by
percutaneous nephrolithotripsy (PNL), a procedure for crushing and removing the
dense stubborn stones characteristic of cystinuria.
The pain with kidney stones is usually of sudden onset,
very severe and colicky (intermittent), not improved by changes in position,
radiating from the back, down the flank, and into the groin. Nausea and
vomiting are common.
Factors predisposing to kidney stones include recent
reduction in fluid intake, increased exercise with dehydration, medications
that cause hyperuricemia (high uric acid) and a history of gout.
Treatment includes relief of pain, hydration and, if
there is concurrent urinary infection, antibiotics.
The majority of stones pass spontaneously within 48
hours. However, some stones may not. There are several factors which influence
the ability to pass a stone. These include the size of the person, prior stone
passage, prostate enlargement, pregnancy, and the size of the stone. A 4 mm
stone has an 80% chance of passage while a 5 mm stone has a 20% chance. If a
stone does not pass, certain procedures (usually by a urology specialist
doctor) may be needed.
The process of stone formation, urolithiasis, is also
called nephrolithiasis. "Nephrolithiasis" is derived from the Greek
nephros- (kidney) lithos (stone) = kidney stone "Urolithiasis" is from the French
word "urine" which, in turn, stems from the Latin "urina"
and the Greek "ouron" meaning urine = urine stone. The stones
themselves are also called renal caluli. The word "calculus" (plural:
calculi) is the Latin word for pebble.
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