UROLITHIASIS

John Kurniawan
UROLITHIASIS
• Urolith : batu saluran kemih
• Urolithiasis : Pembentukan batu saluran kemih; Keadaan
sakit yg disebabkan oleh adanya batu saluran kemih
CLASSIFICATION OF STONES
Urinary stones can be classified according to size, location,
X-ray characteristics, aetiology of formation, composition,
and risk of recurrence

• Stone size
Stone size is usually given in one or two dimensions, and
stratified into those measuring up to 5, 5-10, 10-20, and >
20 mm in largest diameter.
• Stone location
Stones can be classified according to anatomical position:
upper, middle or lower calyx; renal pelvis; upper, middle or
distal ureter; and urinary bladder.
 CLASSIFICATION OF STONES

• X-ray characteristics
Stones can be classified according to plain X-ray
appearance [kidney-ureter-bladder (KUB) radiography]
which varies according to mineral composition
- Radiopak : Calcium oxalat ; calsium fosfat
- Intermediate : Magnesium fosfat ; Apatite ; cystine
- Radiolusen : Asam urat ; amonium urat ; xanthine ; 2,8-
dihydroxyadenine ; drug-stones
 CLASSIFICATION OF STONES

• Aetiology of stone formation

Stones can be classified into those caused by: infection, or non-
infectious causes (infection and non-infection stones); genetic defects;
or adverse drug effects (drug stones)
Non-infection stones
- Calcium oxalate
- Calcium phosphate (including brushite and carbonate apatite)
- Uric acid
Infection stones
- Magnesium ammonium phosphate
- Carbonate apatite
- Ammonium urate
Genetic causes
- Cystine
- Xanthine
- 2,8-dihydroxyadenine
Drug stones
DIAGNOSIS RADIOLOGI
Pasien dengan batu ginjal memberikan gejala nyeri
pinggang, mual-muntah, kadang demam, tetapi kadang tak
bergejala. Standar menetapkan diagnosis : riwayat
penyakit dan pemeriksaan fisik, Radiologi

For stones > 5 mm, US has a sensitivity of 96% and

specificity of nearly 100%.
The sensitivity and specificity of KUB radiography is 44-
77% and 80-87%.
NCCT has become the standard for diagnosing acute flank
pain, and has replaced intravenous urography (IVU), which
was the gold standard for many years. NCCT can
determine stone diameter and density. When stones are
absent, the cause of abdominal pain should be identified.
NCCT should be used to confirm stone diagnosis in
patients with acute flank pain, because it is superior to IVU
NCCT can detect uric acid and xanthine stones, which are
radiolucent on plain films
NCCT can determine stone density, inner structure of the
stone and skin-to-stone distance
BNO-IVU