‫جامعة االنبار‪/‬كلية الطب‪-‬‬

‫المرحلة الرابعة‪-‬‬
‫مشرف المادة ‪:‬د نعمة حمد الهيتي‪-‬‬
‫اعداد الطالب‪ :‬إبراهيم سهيل عبد كنو‪-‬‬

‫‪UROLITHIASIS‬‬
Introduction
The formation of stone in the urinary system, i.e. in the kidney, ureter,
and urinary bladder or in the urethra is called urolithiasis. ‘Urolithiasis’ =
ouron (urine) and lithos (stone). Urolithiasis is one of the major diseases
of the urinary tract and is a major source of morbidity. Stone formation
is one of the painful urologic disorders that occur in approximately 12%
of the global population and its re-occurrence rate in males is 70-81%
and 47-60% in female. It is assessed that at least 10% of the population
in industrialized part of the world are suffering with the problem of
urinary stone formation. The occurrence of the renal calculi is less in the
southern part when compared with other parts. The rate of occurrence
is three times higher in men than women, because of enhancing capacity
of testosterone and inhibiting capacity of oestrogen in stone formation.
The problem of stone formation is considered as a medical challenge
due to its multifactorial etiology and high rate of reoccurrence. Stone
formation is also caused due to imbalance between promoters and
.inhibitors
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
 Many calculi do not cause symptoms; they may be found incidentally
through radiology exams.
– Symptoms arise when calculi cause partial or complete obstruction
and/or infection:
• Intermittent, acute flank to pelvic pain (renal colic). Pain can be severe
and typically causes nausea and vomiting. Abdomen/flank may be
tender to palpation. Patients are typically restless, finding no
comfortable position.
• Haematuria and/or gravel (calculi) passed in urine.
• Fever and signs of pyelonephritis if secondary infection develops 

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.
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.

Kidney stones are diagnosed by excluding other possible causes of

abdominal pain and associated symptoms. Imaging tests including an X-
ray called a KUB view (kidney, ureter, bladder), or a helical CT scan are
often used to confirm the diagnosis of kidney stones.

Treatment includes relief of pain, hydration and, if there is concurrent

urinary infection, antibiotics.

If your kidney stones are too big to be passed naturally, they're usually
removed by surgery.

The main types of surgery for removing kidney stones are:

 shockwave lithotripsy (SWL)

 ureteroscopy

 percutaneous nephrolithotomy (PCNL)

The type of surgery will depend on the size and location of the stones.

 
Referances

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