Urinary tract stone disease involves the diagnosis and treatment of kidney (renal) stones, as well as those kidney stones which move down the ureter tube. Those stones may cause acute severe pain called renal colic, typically flank pain with nausea, which may require strong analgesia. Stones may also form primarily in the urinary bladder, but those are usually in the male due to bladder outlet obstruction from an enlarged prostate gland.
Most stones are formed from calcium and oxalate minerals, and can have a family tendency. Generally those who live in hot climates or have hot work environments are at risk. A small number of patients have uric acid (urate) stones , while far less commonly cystine stones are found. A high fluid intake can reduce the incidence and recurrence rate of stones.
Kidney stones may be treated with observation, external shock wave lithotripsy (ESWL), internal laser by ureteroscopy telescope, or occasionally by keyhole surgery. Open stone surgery is very uncommon. Occasionally complete kidney removal (nehrectomy) is used if the kidney has become chronically infected or has ceased to function. Some very large "staghorn" stones are dealt with by keyhole surgery through the flank called PCNL.
Stone management is very dependent on the size and location of stones, and imaging with CT scans is most useful. An ultrasound alone will not accurately show the presence or absence of stones, and is not to be relied upon.
Most stone treatment can take place as day stay surgery, although multiple treatments or procedures may be required for complex stones.