Friday, 2 January 2015

Clinical Manifestation in Urolithiasis

History Taking

Factor determining the symptoms

  • size of stone
  • location of stone
  • production of urinary outflow obstruction
  • movement of the stone (eg: from renal pelvis to bladder)
  • presence of infection

1. Renal stone

  • renal colic  (colicky (comes in waves) due to ureteric peristalsis)
  • hematuria
  • passing out stone
  • loin pain
  • secondary infection
    • urinary tract infection
    • sepsis
2. Ureteric stone
  • ureteric colic - radiated to the scrotum/labia
  • nausea and vomiting
3. Bladder stone
  • irritative bladder symptoms
  • pain radiated to tip of penis
  • obstructive symptoms
4.Uretheric stone

Commonest chief complaints according to percentage
  1. pain
  2. fever
  3. recurrent UTI
  4. hematuria
  5. palpable mass
  6. malaise
  7. asymptomatic
Complication of staghorn calculi
  1. severe renal deterioration
  2. sepsis
  3. azotemia
  4. death

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