Urolithiasis: Difference between revisions
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== Treatment == | == Treatment == | ||
-Morphine and NSAIDS<br> | |||
-IVF of no benefit in acute setting | |||
== Surgical Treatment<br> == | |||
Persistent obstruction, failure of stone progression, or increasing or unremitting colic | |||
Shock wave lithotripsy, ureteroscopy, or percutaneous nephrolithotomy | |||
== Source == | == Source == | ||
Revision as of 08:09, 26 July 2011
Type
Calcium 75%
-hyperparathyroidism, hypercalcemia of malignancy, sarcoidosis, increased absorption from gut; thiazide diuretics; topiramate, protease inhibitors (indinavir or sulfadiazine)
Struvite 15%
-Proteus, Klebsiella, Pseudomonas, Staphylococcus
Uric Acid 6%
Pass Rates
Size
4mm ~75%
4-6mm ~50%
>6mm ~10%
Location in Ureter
- Distal ~70%
- Middle ~50%
- Proximal ~20%
Recurrence Rates
1 yr ~33%
5yr ~50%
- Incresing H2O intake decreases rate
- Protease inhibitors and diuretics increases rate
Differential Dx
Cholelithiasis (5%)
Appy (4%)
Pyelonephitis (3%)
Ovarian cyst (2%)
Renal mass (1.4%)
AAA w/or w/o rupture (1.4%)
Treatment
-Morphine and NSAIDS
-IVF of no benefit in acute setting
Surgical Treatment
Persistent obstruction, failure of stone progression, or increasing or unremitting colic
Shock wave lithotripsy, ureteroscopy, or percutaneous nephrolithotomy
Source
10/07 DONALDSON (adapted from Tintinalli)