Urolithiasis is a term used to describe calculi or stones that form the urinary tract. It involves the formation of calcifications in the urinary system, usually in the kidneys or ureters, but may also affect the bladder or urethra.
It is a common condition that with various risk factors and causes, including lifestyle habits and other practices.
Renal stones are a common health condition, estimated to affect up to 10% of all individuals will develop a kidney stone throughout their lifetime although some individuals do not experience symptoms. Each year, approximately 1 per 1000 population is hospitalized due to urolithiasis.
Men are more likely to have urolithiasis than women, with a risk ratio of 3:1, although this gap appears to be narrowing over time. People aged between 20 and 40 years are at the highest risk of developing stones.
This risk of urolithiasis increases as a result of any factor that leads urinary stasis due to a reduction or obstruction of urinary flow.
Certain risk factors contribute to a higher incidence of stone formation, including:
The exact symptoms of urolithiasis depend on the location and size of the calculi in the urinary system. General signs and symptoms may include:
Stones in the kidneys can obstruct the urinary flow in the kidneys or the ureters, leading to severe flank pain and possibly blood in the urine. Stones in the bladder can lead to symptoms such as pain and increased urge and frequency of urination.
The diagnosis of urolithiasis involves a medical history and a physical examination, in addition to appropriate testing methods to identify the calculi and make the appropriate treatment decisions. This may include:
The management of urolithiasis will depend on the specific patient case, based on factors such as the presenting symptoms and the size and location of the stones.
Most stones are excreted in the urine on their own and do not require invasive surgical techniques. Keeping hydrated to flush the stones out of the body is recommended initially if the pain is manageable for the patient. Simple analgesic medication such as paracetamol can aid pain relief.
In an acute situation, analgesic medications such as non-steroidal anti-inflammatory drugs (NSAIDs) or codeine can be administered to relieve pain. Antiemetic medication and rehydration therapy may also be useful. Medical expulsive therapy can be used to facilitate the passing of the stone. For larger stones that do not pass spontaneously, surgery may be needed to remove the calculi.