Pickard R, Starr K, MacLennan G, Lam T, Thomas R, Burr J, et al.

[Ignatoff JM, Nelson JB.
IVP is widely available and fairly inexpensive but less sensitive than noncontrast helical CT. CT scanning with delayed contrast series and thin slices has reduced the need for IVP in the evaluation of problematic ureteral stones.

Nephrolithiasis: acute renal colic. Wang Z, Xu L, Su Z, Yao C, Chen Z. Invasive management of proximal ureteral calculi during pregnancy. Single stones of the lower pole of the kidney. Tasian GE, Copelovitch L. Evaluation and medical management of kidney stones in children. Observing even a relatively large radiopaque stone located in the kidney or renal pelvis on a standard abdominal flat plate radiograph can be difficult or impossible if the patient has abundant gas or stool overlying the area, and plain renal tomography can often overcome this difficulty.Plain renal tomography may be helpful for clarification of stones not clearly detected or identified with other studies (eg, differentiating intrarenal calcifications that are likely to be stones from extrarenal opacities that are clearly not renal calculi). Gadolinium contrast, however, is contraindicated if the estimated glomerular filtration rate is less than 30, owing to the risk of nephrogenic systemic fibrosis.Use of MRI in pregnant patients is somewhat controversial. Repeat laboratories along with a 1,25 vitamin D-3 level are confirmatory.Phosphate supplements are used to correct the low serum phosphate level, which then decreases the inappropriate activation of vitamin D originally caused by the hypophosphatemia. For now, additional studies on this technique are needed before the intrarenal resistive index can be reliably used for diagnosing acute renal colic and ureteric obstruction.Future studies may utilize 2-dimensional ultrasonography in combination with color Doppler analysis of the ureteral jets to enhance sensitivity of ultrasonography in patients with ureteral colic.Before the advent of helical CT, IVP, also known as intravenous urography (IVU), was the test of choice in diagnosing ureterolithiasis. Guidelines from the American College of Radiology (ACR) recommend noncontrast CT as the most appropriate radiologic procedure for both suspected stone disease and recurrent symptoms of stone disease.

It is the initial imaging modality of choice for pregnant patients with acute renal colic because it avoids all potentially hazardous ionizing radiation.Ultrasonography relies on indirect visualization clues to identify stones. Bolus administration is usually recommended for renal colic evaluations because it allows for a nephrogram-effect phase film. Failure to perform rapid renal decompression can perpetuate urosepsis and result in death.

Neutra-Phos-K powder for solution is a urinary acidifier.

Epocrates Online Contact us.

PLoS One. In general, if the number of white blood cells (WBCs) in the urine is greater than 10 cells per high-power field or greater than the number of RBCs, suspect a UTI. Cochrane Database Syst Rev. Nerve supply of the kidney. Obtaining the IVP is also a relative labor-intensive process. BMC Urol. Laparoscopic anatrophic nephrolithotomy: developments of the technique in the era of minimally invasive surgery. Does tamsulosin enhance lower ureteral stone clearance with or without shock wave lithotripsy?. Philadelphia, PA: Saunders Elsevier; 2007:1431-1507.Zhu Y, Duijvesz D, Rovers MM, et al. Porpiglia F, Destefanis P, Fiori C, Scarpa RM, Fontana D. Role of adjunctive medical therapy with nifedipine and deflazacort after extracorporeal shock wave lithotripsy of ureteral stones.

Treatment selection and outcomes: renal calculi.

Alpha blockers for treatment of ureteric stones: systematic review and meta-analysis. A large extrarenal pelvis or UPJ obstruction can easily be misread for hydronephrosis if ultrasonography alone is used.Middleton et al reported perhaps the most successful use of ultrasonography for renal colic: a 91% stone detection rate.

)This study may be particularly useful in pregnancy (when exposure to ionizing radiation must be minimized), severe contrast media allergy, and azotemia. BJU Int. Clinical effectiveness protocols for imaging in the management of ureteral calculous disease: AUA Technology Assessment. Kingo PS, Ryhammer AM, Fuglsig S. Clinical experience with the Swiss lithoclast master in treatment of bladder calculi. Ureteroscopy or PCNL can be utilized when ESWL fails, or in the presence of anatomic abnormalities or other special circumstances.

Although many staghorn calculi are struvite (related to infection with urease-splitting bacteria), the density of this stone suggests that it may be metabolic in origin and is likely composed of calcium oxalate. Kidney Stones.

If there is spontaneous passage of stones, most pass within 4 to 6 weeks. 1999 Jul-Aug;13(6):441-4. 2015;(10):CD010057.