| Abstract: |
This lengthy chapter about urinary stone disease is from an updated edition of a comprehensive textbook about urology that offers an overview of the diagnosis and treatment of diseases and disorders common to the genitourinary tract. The author notes that urinary stones are common, yet their cause remains uncertain. The author begins with a discussion of the etiology, role of urinary ions, stone varieties, and symptoms and signs at the presentation of urinary tract stones. Symptoms can include pain, hematuria, infection, associated fever, nausea, and vomiting. The author reviews diagnostic approaches to urinary stones and outlines the treatment options, including conservative observation, dissolution agents, relief of obstruction, extracorporeal shock wave lithotripsy, ureteroscopic stone extraction, percutaneous nephrolithotomy, open stone surgery, pyelolithotomy, anatrophic nephrolithotomy, radial nephrotomy, and ureterolithotomy. The chapter includes a section on special situations, including renal transplantation, pregnancy, dysmorphia, obesity, medullary sponge kidney, renal tubular acidosis, associated tumors, pediatric patients, caliceal diverticula, and kidney malformations. Prevention strategies are also outlined, including metabolic evaluation and the use of oral medications. A brief review of bladder, urethral, and prepucial stones is given. The chapter is illustrated with numerous black-and-white drawings and photographs. The chapter concludes with an extensive list of references, categorized by topic. 24 figures. 110 references. |