What is the difference between nephrolithiasis and ureterolithiasis

They are made of calcium compounds, including calcium oxalate and calcium phosphate. High levels of calcium and oxalate in the body increase the risk of developing calcium stones. There are some medical conditions that can lead to high levels of calcium, including hyperparathyroidism. Uric acid is a waste product that is normally passed out of the body in the urine.

Some people have a buildup of uric acid, which can lead to uric acid kidney stones. There are some factors that can increase risk for this type of kidney stone, including:. Struvite stones are sometimes called infection stones because they can occur with urinary tract infections UTIs. If struvite stones are large, they are also known as staghorn calculi.

The cornerstones of ambulatory management are adequate analgesia, timely urologic consultation and close follow-up. Numerous medical strategies have been attempted to control colic, which can be attributed to ureteral spasm. Although narcotics such as codeine, morphine and meperidine Demerol are effective in suppressing pain, they do nothing to treat its underlying cause, and they have the side effects of dependence and disorientation.

As a result of combined anti-inflammatory and spasmolytic effects, nonsteroidal anti-inflammatory drugs NSAIDs such as aspirin, diclofenac Voltaren and ibuprofen e. Of these agents, ketorolac Toradol merits special mention. In one emergency department study, the narcotic-like analgesic effects of this agent were superior to the effects of meperidine.

The cyclooxygenase-2 inhibitors, a new class of NSAIDs, may prove to be effective agents in the management of renal colic. Theoretically, these drugs do not impair platelet function. To date, however, there have been no reports of their use in patients with renal colic. At present, an effective approach to outpatient management is to use both an oral narcotic drug and an oral NSAID. Patients are instructed not to take NSAIDs for three days before anticipated extracorporeal shock wave lithotripsy; they are also told to avoid taking aspirin for seven days before the procedure.

Spasmolytic medications, such as calcium channel blockers and glucagon, have no value in the management of acute colic. After emergency situations have been ruled out and adequate analgesia has been achieved, the next step is to formulate a strategy for managing the stone.

Clinical experience with urolithiasis has been refined with statistical analysis to provide sound principles for definitive management. Ureteral calculi: natural history and treatment in the era of advanced technology. The natural history of asymptomatic urolithiasis. J Urol ;— The likelihood that a ureteral stone will pass appears to be determined by its size i. Stones less than 5 mm in size should be given an opportunity to pass. Patients can be advised that stones less than 4 mm in size generally pass within one to two weeks.

With stones of this size, 80 percent of patients require no intervention beyond analgesia. Patients with a radiopaque ureteral stone who elect a conservative approach should be advised to have regular follow-up KUB radiographs at one- to two-week intervals.

They should also strain their urine to capture stones or stone fragments, because stone composition provides important information for the prevention of future stones.

Patients should be cautioned to seek immediate medical attention if they develop signs of sepsis. The principal message should be that medical surveillance must be continued until stone passage is documented. Although unlikely with small calculi, asymptomatic complete ureteral obstruction may destroy renal function in as little as six to eight weeks. As stones increase in size beyond 4 mm, the need for urologic intervention increases exponentially.

Referral to a urologist is indicated for patients with a stone greater than 5 mm in size. Referral is also indicated for patients with a ureteral stone that has not passed after two to four weeks of observation.

The complication rate for ureteral calculi has been reported to almost triple to 20 percent when symptomatic stones are left untreated beyond four weeks. Renal stones, which are generally asymptomatic, may be followed conservatively. However, patients can be advised that about 50 percent of small renal calculi become symptomatic within five years of detection.

Persons in some occupations, most notably airplane pilots, are not permitted to work with even an asymptomatic renal stone, for fear of the unpredictable onset of incapacitating pain while they are involved in a crucial task.

These patients obviously require early definitive therapy. Staghorn renal calculi, which are frequently the result of, and a persistent focus for, chronic infection are clearly associated with renal damage. Renal calculi less than 2 cm in size can generally be treated with extra corporeal shock wave lithotripsy. Stones in a lower pole calyx are an exception, as they are associated with poor clearance rates after extra corporeal shock wave lithotripsy, and 1 cm is the generally recommended upper limit for this treatment.

Extracorporeal shock wave lithotripsy is also effective for ureteral stones, with an upper size limit of approximately 1 cm. Unknown ovarian effects are the basis for a relative contraindication to the use of extracorporeal shock wave lithotripsy in women of child-bearing age who have middle or distal ureteral stones.

Percutaneous nephrolithotomy remains a safe and reliable method of removing large renal and proximal ureteral stones. Advances in ureteroscopic techniques now allow calculi that are not good candidates for extracorporeal shock wave lithotripsy or percutaneous nephrolithotomy to be treated virtually anywhere within the ureter or kidney. Requires spontaneous passage of fragments Less effective in patients with morbid obesity or hard stones.

Ureteral obstruction by stone fragments Perinephric hematoma. Invasive Commonly requires postoperative ureteral stent. May be difficult to clear fragments Commonly requires postoperative ureteral stent. Bleeding Injury to collecting system Injury to adjacent structures. Already a member or subscriber?

Log in. Interested in AAFP membership? Learn more. Portis completed a residency in urology at the University of Alberta, Edmonton, Canada. Address correspondence to Chandru P. Sundaram, M. Louis, MO Reprints are not available from the authors. Urinary lithiasis: etiology, diagnosis and medical management.

In: Walsh PC, et al. Campbell's Urology. Philadelphia: Saunders,— The first kidney stone. Ann Intern Med. A prospective study of dietary calcium and other nutrients and the risk of symptomatic kidney stones.

N Engl J Med. Factitious renal colic. Eur Radiol. Ureteral calculi in patients with flank pain: correlation of plain radiography with unenhanced helical CT. A comparison of noncontrast computerized tomography with excretory urography in the assessment of acute flank pain.

J Urol. Prospective comparison of unenhanced spiral computed tomography and intravenous urogram in the evaluation of acute flank pain. Katzberg RW. Urography into the 21st century: new contrast media, renal handling, imaging characteristics, and nephrotoxicity. Rasuli P, Hammond DI. Metformin and contrast media: where is the conflict?

Can Assoc Radiol J. Metformin and contrast media—a dangerous combination? Clin Radiol. Diagnosis of acute flank pain: value of unenhanced helical CT. Helical CT of urinary tract stones. Epidemiology, origin, pathophysiology, diagnosis, and management.

Radiol Clin North Am. Can noncontrast helical computed tomography replace intravenous urography for evaluation of patients with acute urinary tract colic? J Emerg Med. Learn how we develop our content. To learn more about Healthwise, visit Healthwise. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. Updated visitor guidelines.

You are here Home » Types of Kidney Stones. Top of the page. Topic Overview There are four main types of kidney stones. Calcium stones Most kidney stones are made of calcium compounds, especially calcium oxalate. Certain medicines may prevent calcium stones.

Uric acid stones Some kidney stones are made of uric acid , a waste product normally passed out of the body in the urine. You are more likely to have uric acid stones if you have: Low urine output. A diet high in animal protein, such as red meat. An increase in how much alcohol you drink. Inflammatory bowel disease.