Urinary Stone Disease: Diagnosis, Medical Therapy, and Surgical Management

Wesley W Ludwig; Brian R Matlaga

doi:10.1016/j.mcna.2017.10.004

Urinary Stone Disease: Diagnosis, Medical Therapy, and Surgical Management

Med Clin North Am. 2018 Mar;102(2):265-277. doi: 10.1016/j.mcna.2017.10.004. Epub 2017 Dec 9.

Authors

Wesley W Ludwig¹, Brian R Matlaga²

Affiliations

¹ Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins Hospital, The Johns Hopkins University School of Medicine, 600 North Wolfe Street, Marburg 134, Baltimore, MD 21287, USA. Electronic address: wludwig1@jhmi.edu.
² Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins Hospital, The Johns Hopkins University School of Medicine, 600 North Wolfe Street, Marburg 134, Baltimore, MD 21287, USA.

PMID: 29406057
DOI: 10.1016/j.mcna.2017.10.004

Abstract

Clinical suspicion of urolithiasis should be evaluated with low-dose computed tomography as the first-line imaging modality for nonpregnant, adult patients. A period of observation may be appropriate for ureteral stones less than 10 mm, and medical expulsive therapy may be beneficial for facilitating passage of distal ureteral stones. Regardless of stone type, patients should adhere to a low-sodium diet and attempt to achieve a urine volume of more than 2.5 L daily. Individuals with calcium stones should maintain a normal calcium diet, and if stones persist, citrate therapy or thiazide diuretics in the setting of hypercalciuria may be indicated.

Keywords: Dietary therapy; Extracorporeal shockwave lithotripsy; Medical therapy; Percutaneous nephrolithotomy; Ureteroscopy; Urolithiasis.

Publication types

Review

MeSH terms

Humans
Urinary Calculi / diagnosis*
Urinary Calculi / pathology
Urinary Calculi / therapy*
Urolithiasis / diagnosis*
Urolithiasis / pathology
Urolithiasis / therapy*