Coronal CT image showing thickened left ureter white arrow and moderate hydronephrosis of the left kidney red arrow CT: Articles from Cureus are provided here courtesy of Cureus Inc. Shock wave lithotripsy The introduction of shock wave lithotripsy in the early s revolutionised the treatment of nephrolithiasis. J Urol ; 3 Pt 2: The pathological features of UC include areas of glandular metaplasia secondary to chronic urothelial inflammation.
Percutaneous nephrolithotomy results in higher stone-free rates and lower retreatment rates than shock wave lithotripsy. Physical examination often reveals costovertebral angle or lower abdominal tenderness. How is the diagnosis made? Other etiological factors that have been postulated include schistosomiasis, vitamin A excess, and increased immunoglobulin A [ 2 ]. Biopsies were taken and showed signs of chronic inflammatory changes consistent with this diagnosis. Per the operative report, the region of the ureter thickening had the gross appearance of ureteritis cystica.
While parenteral narcotics have traditionally been prescribed for acute renal colic, 8 non-steroidal anti-inflammatory drugs such as ketorolac and diclofenac are effective in relieving pain by inhibiting prostaglandin mediated pain pathways and decreasing ureteral contractility.
It contains educational material for patients as well as a description of the ongoing research projects in the area scrigd kidney stone disease National Institute of Diabetes and Digestive and Kidney Diseases NIDDK Information Clearinghouse www.
However, our patient developed bilateral ureter obstruction associated with an acute kidney injury, which has not been previously reported. Morgagni first reported UC in [ 1 ]. JEL reviewed, revised, and approved the final paper and will serve as guarantor. A retrospective study showed that ureteroscopy scribe useful when urolithisis fails; when complex or lower pole renal calculi are present 14 ; or when patient factors such as pregnancy, coagulopathy, or morbid obesity preclude lithotripsy.
Management of kidney stones
Radiographically, a differential diagnosis of multiple transitional cell tumors, ureteral pseudodiverticula, non-opaque calculi, polyps, papillary tumors, tuberculosis, iatrogenic gas bubbles, gas-forming microorganisms, and submucosal hemorrhage can be considered with an appropriate clinical correlation [ 4 ]. Ureteroscopy is an increasingly used alternative for treating simple renal calculi because it has similar stone-free rates to shock shudy lithotripsy and morbidity is lower than with percutaneous nephrolithotomy.
J Urol ; 3 Pt 1: The case for primary endoscopic management of upper urinary tract calculi. Percutaneous nephrolithotomy Percutaneous nephrolithotomy involves creating an access tract into the renal urolithiais system through which nephroscopy can be performed.
This case may demonstrate an idiopathic origin of ureteritis cystica, although the bilateral and diffuse involvement, lack of previous urological history, and patient age are unusual and may warrant further workup towards other diagnoses. The decision making process can be simplified by stratifying stones into clinical categories based on location renal or ureteral and complexity simple or complex.
Cochrane Database Syst Rev ; 1: The diagnosis is usually made during ureteroscopy or during radiography. Medical expulsive therapy This treatment comprises the use of drugs to help the spontaneous passage wtudy ureteral calculi. The nephroscope has a working channel through which an intracorporeal lithotripsy device lithotrite or laser can be introduced.
Royal Infirmary of Edinburgh Renal Unit http: N Engl J Med ; Ureteral calculi most commonly present with symptoms of acute renal colic. Assessment should include measurement of vital signs because fever may be an indication for acute intervention box 2.
Ureteritis Cystica: An Unusual Presentation in an Otherwise Healthy Female
Shock wave lithotripsy, ureteroscopy, and percutaneous nephrolithotomy have replaced open surgery urolthiasis treating urolithiasis. Journal List Cureus v. Acute renal colic from ureteral calculus. The management of lower pole calyceal calculi remains controversial. Open surgery was the mainstay of treatment for urolithiasis, but it has now been supplanted by less invasive treatments. This article has been cited by other articles in PMC.
Conventional and alternative methods for providing analgesia in renal colic. Tamsulosin treatment increases clinical success rate of single extracorporeal shock wave lithotripsy of renal stones. Ureteroscopy involves retrograde visualisation of the collecting system using a rigid, semi-rigid, or flexible endoscope.
European Association of Urology, Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria. Comorbid diseases should be identified, particularly any systemic illnesses that might increase the risk of kidney stone formation or that might influence the clinical course of the disease box 1.
Small filling defects and a bead-like appearance with regular surfaces in the ureter and renal pelvis are the typical findings demonstrated in intravenous or retrograde pyelogram.
Management of kidney stones
The characteristics of the stones size, number, location, and compositionrenal anatomy, and clinical factors are all considered when selecting a treatment approach for renal calculi. In human and animal models it can cause acute renal uroltihiasis.
Box 2 lists the indications for acute intervention.