Urinary calculi

Extract

• The treatment of an acute attack should be started with an intramuscular or intravenous NSAID, a combination of an analgesic and a spasmolytic, or an opioid at the health care facility that the patient first attends.
• Bacterial culture of urine, chemical screening of urine and plasma creatinine should be done/checked.
• The diagnosis should be confirmed with ultrasonography, in specialized care with CT scan. The vitality of the kidneys should be verified by follow-up.
• Attempts should be made to retrieve the stone by straining urine and to analyze the composition of the stone.
• Careful history taking and basic laboratory tests are indicated after the first attack, already, to lower the risk of recurrence.
• In the case of recurrent urinary calculi, the aim should be to lower the concentration of lithogenic factors (primarily calcium and oxalate) in urine and to increase the urine citrate concentration (citrate prevents the formation of calculi).
• Lifestyle modification is indicated in all patients, the most important change being drinking plenty of liquids so as to make the daily urine excretion 2 litres, at least.

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Abdominal Pain, Diclofenac, Hypercalciuria, Indomethacin, Ketoprofen, Kidney Calculi, Lithotripsy, N20*, N21*, N22*, N23, Oxalates, Pain, Surgery, Thiazides, Ureterolithiasis, Uric Acid, Urinary Tract Infections, Urolithiasis, Urology, calcium oxalate stone, conservative treatment, cystine stone, lithotomy, lower abdominal pain, prostaglandin antagonists, uric acid stone