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Angeles University Foundation
Angeles City
uROLItHiAsIs
A case reportSubmitted by:Ano, Carl ElexerBalilo, Noel LeonicioEstrada, Florence Ancel Tumaliwan, CharmaineSubmitted to:Mark Anthony Paras, R.N., M.N. January 8, 2009
 
Introduction
Urolithiasis. The process of forming stones in the kidney, bladder,and/or urethra (urinary tract). Kidney stones are a common cause of blood in the urine and pain in the abdomen, flank, or groin. Kidneystones occur in 1 in 20 people at some time in their life. The pain with kidney stones is usually of sudden onset, verysevere and colicky (intermittent), not improved by changes in position,radiating from the back, down the flank, and into the groin. Nauseaand vomiting are common. Factors predisposing to kidney stonesinclude recent reduction in fluid intake, increased exercise withdehydration, medications that cause hyperuricemia (high uric acid)and a history of gout. Treatment includes relief of pain, hydration and, if there isconcurrent urinary infection, antibiotics. The majority of stones passspontaneously within 48 hours. However, some stones may not. Thereare several factors which influence the ability to pass a stone. Theseinclude the size of the person, prior stone passage, prostateenlargement, pregnancy, and the size of the stone. A 4 mm stone hasan 80% chance of passage while a 5 mm stone has a 20% chance. If astone does not pass, certain procedures (usually by a urology specialistdoctor) may be needed. The process of stone formation, urolithiasis, is also callednephrolithiasis. "Nephrolithiasis" is derived from the Greek nephros-(kidney) lithos (stone) = kidney stone "Urolithiasis" is from the Frenchword "urine" which, in turn, stems from the Latin "urina" and the Greek"ouron" meaning urine = urine stone. The stones themselves are also
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called renal caluli. The word "calculus" (plural: calculi) is the Latin wordfor pebble.Medical Therapy and New Approaches to UrolithiasisExtracorporeal Shockwave lithotripsy, this technology hasreduced considerably the morbidity of stone disease, by allowingrelatively noninvasive removal of stones. Unfortunately, the facilitatedremoval of stones by ESWL has led some urologists to abandon ordisparage the medical approach to stone management. The propensityfor stone recurrence is not altered by removal of stones with ESWL.Ample evidence has accumulated, however, showing that a variety of medical treatments can prevent recurrence of stones. There have been notable advances in the medical managementof urolithiasis. A graphic display of stone risk factors is now availablecommercially. A step-by-step approach to diagnosis and treatment of different causes of urolithiasis was described in 1996.Step 1.History and minimum diagnostic testsStep 2. 24-hour urinary stone risk profile(cstomary diet)Identification of abnormal dietary risk factorsShort-term dietary modificationStep 3. Repeat stone risk profile after dietary modificationStep 4. Elucidation of causes and construction of treatmentoptions for abnormal risk factorsA full 24-hour stone risk profile is measured on a random dietand fluid intake. Another stone risk profile is obtained after a short-term dietary modification.
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