Stones usually form in the collecting ducts of the kidneys but may be deposited along the entire urogenital tract from the renal pelvis to the urethra. Their localization and size determine the specific symptoms.
Location and characteristics of pain
Depends on the level of obstruction and its degree:
UPJ (Ureteropelvic junction) stone:
UVJ (Ureterovesical junction) stones:
Urine analysis - Gross or microscopic haematuria
Urine pH: > 7 suggests urea-splitting organisms and struvite stones, < 5 indicates uric acid stones
Urine microscopy: to detect crystals
Urine culture: in patients with s/s of UTI
24-hour urine profile
↑ WBC: suggests concomitant UTI
↑ Serum urea nitrogen and creatinine: suggests acute kidney injury
Abdomino pelvic CT : Non enhanced CT scan is the gold standard.
X-ray (KUB) - Not useful for evaluating calcium stones < 3 mm, radiolucent stones, or to identify urinary tract obstruction
Intravenous pyelogram (IVP): rarely used
Treatment depends on the size of the stone