renalcalculi

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Renal Calculi: 

Renal Calculi Nephrolithiasis Kidney Stones Leslie Brady

Renal Calculi: 

Renal Calculi Anatomy Urine Production Etiology Diagnosis Imaging Method Prognosis Treatment

Anatomy of the Urinary System: 

Anatomy of the Urinary System Kidneys Ureters Bladder KUB

Slide 5: 

Kidneys Main organ Homeostasis Secrete hormones Balance pH Balance minerals Urine production

Slide 8: 

Urine Production Filtration Reabsorption Secretion

Slide 9: 

Urine Production Filtration

Slide 10: 

Kidney Filtration Renal artery Glomerular capsule Nephrons

Slide 12: 

Kidney Reabsorption Carrier molecules Renal vein Waste

Filtration, Reabsorption, Secretion: 

Filtration, Reabsorption, Secretion

Slide 14: 

Kidney Secretion Substances Waste Collecting duct

Slide 15: 

(10) Cortex (9) Renal column (8) Pyramid (7) Papilla (6) Minor calyx (5) Major calyx (4) Renal pelvis

Types of Calculi: 

Types of Calculi

Etiology: 

Etiology Metabolic abnormality Urologic abnormality Diet

Metabolic Abnormality: 

Metabolic Abnormality Hyperparathyroidism Dehydration Hypovolemia Hypercalciuria Hypocitraturia

Urologic Abnormality: 

Urologic Abnormality Urinary tract infection Congenital defect UT Obstruction

Diet: 

Diet High protein and fat Low Carbohydrate

Diagnosis: 

Diagnosis Pain (renal colic) Frequent urination Hematuria Nausea Vomiting Burning sensation Fever Chills

Imaging Methods: 

Imaging Methods Abdominal radiograph IVU (IVP) CT non-contrast Retrograde pyelogram Ultrasound

KUB : 

KUB

Rule Out: 

Rule Out Gallstones Diverticulitis Intestinal Blockage Blood clots IBS Appendicitis Stomach Ulcers Hiatal Hernia Pancreatitis Pelvic Inflammatory Disease Crohn’s Disease Colitis Heart Attack

Prognosis: 

Prognosis Duration Complications Outcomes Recovery Survival rates Death rates

Slide 40: 

<4mm easily passed 90% 5-7mm passed 50% >7mm unlikely to pass without intervention

Slide 41: 

“The stone was so big you'd want to wear it on your finger. If you subjected it to extreme heat, it might turn out to be a diamond.”

Treatment: 

Treatment Pass stones Lithotripsy Nephrolithotomy

Lithotripsy: 

Lithotripsy Extracorporeal Shock Wave Lithotripsy (ESWL) Laser Lithotripsy Electrohydraulic Lithotripsy (EHL) Pnuematic Mechanical Lithotripsy Ultrasonic Lithotripsy Intracorporeal

Slide 47: 

Extracorporeal Shock Wave Lithotripsy (ESWL) Least invasive Multiple or single stones Kidney or upper urinary tract Side effects Risks Contraindications

Intracorporeal: 

Laser Lithotripsy Ureteroscopy Basket extraction Contraindications Holmium Pulsed-dye Ureteroscopy Video Intracorporeal

Intracorporeal: 

Electrohydraulic Lithotripsy (EHL) First method Inexpensive Not safe Pneumatic Mechanical Lithotripsy Inexpensive Distal ureter Jackhammer Ultrasonic Lithotripsy Distal ureter High frequency sound Irrigates and sucks Intracorporeal

Lithotomy: 

Lithotomy Percutaneous Nephrolithotomy (PCNL or PNL) Large renal calculi Staghorn Blockage ESWL fails

Slide 63: 

Percutaneous Access

Slide 66: 

Dilation

Slide 67: 

Sheath

Slide 68: 

Nephroscope

Cool Web Sites: 

http://urologystone.com http://www.bl.uk/learning/artimages/bodies/bodies.html http://www.or-live.com/ http://www.urolog.nl http://www.youtube.com http://www.medcyclopaedia.com/library/radiology Cool Web Sites

The End: 

The End