19/03/2026
Stone Information Very Informative
by
Dr SyedHassan's Urology Center
Idrees Hospital Sialkot Cantt
Whtsapp 03377876255
*Definition*: Formation of all types of urinary calculi in the kidney, which may deposit along the entire uro‑genital tract from renal pelvis to urethra.
*Epidemiology*:
- Male : female ratio = 3:1.
- Peak age: 30–50 years.
- Risk factors:
- Personal or family history.
- Low fluid intake / dehydration.
- Loop diuretics.
- Post‑gastrectomy or post‑parathyroidectomy.
- Stone composition often involves calcium oxalate crystal growth (magnesium inhibits it).
Dr SyedHassan's Urology Center
Idrees Hospital Sialkot Cantt
Whtsapp 03377876255
*Clinical Features*:
- Stones usually form in collecting ducts but may deposit anywhere in the uro‑genital tract.
- Small stones may be asymptomatic & detected incidentally.
- Severe unilateral acute flank pain (renal colic).
- Pain radiates anteriorly to groin or sc***um.
- Paroxysmal & progressively worsening.
- Costovertebral angle tenderness.
- Associated symptoms: hematuria, nausea/vomiting, diaphoresis, tachycardia, tachypnea.
- Dysuria, frequency & urgency (urethral irritation).
- Passage of gravel or stone.
- Obstruction may cause inability to pass urine & renal colic.
- Fever, chills, rigors → possible pyelonephritis (infection).
Dr SyedHassan's Urology Center
Idrees Hospital Sialkot Cantt
Whtsapp 03377876255
*Classification*: (partially shown in the image) involves categorizing stones by composition (e.g., calcium oxalate, uric acid, etc.) and location in the urinary tract.
Dr SyedHassan's Urology Center
Idrees Hospital Sialkot Cantt
Whtsapp 03377876255
*Calcium oxalate stones* (≈80% incidence)
- Crystal: Biconcave dumbbells or pyramidal envelopes.
- Radiopacity: Radiopaque (X‑ray/CT – white).
- Prophylaxis: urine alkalinization (citrate).
- Causes: hypercalciuria, hyperoxaluria, hypocitraturia, ethylene glycol (antifreeze) & vit C excess, IBD.
- Tx: hydration, dietary mod (↓ oxalate, ↓ vit C), restrict calcium intake, thiazide diuretics.
Dr SyedHassan's Urology Center
Idrees Hospital Sialkot Cantt
Whtsapp 03377876255
2. *Uric Acid stones* (≈5–10% incidence)
- Crystal: rounded rhomboids, rosettes or needle‑shaped.
- Radiopacity: Radiolucent (X‑ray – transparent).
- Prophylaxis: urine alkalinization.
- Seen in gout, hyperuricemia, desert climates, high cell turnover (chemotherapy).
- Tx: hydration, oral chemolysis (urine alkalinization), low purine diet, allopurinol if high urine uric acid.
3. *Struvite (magnesium ammonium phosphate) stones* (≈6–10%)
- Crystal: rectangular prisms (coffin lid appearance).
- Radiopacity: weakly radiopaque (X‑ray/CT – gray).
- Prophylaxis: urine acidification.
- Associated with UTI & urea‑producing bacteria; alkaline urine → phosphate salt crystal formation (staghorn calculus).
- Tx: hydration, treat UTI, urine acidification, often surgical removal.
4. *Calcium Phosphate stones* (≈5%)
- Crystal: wedge‑shaped prisms.
- Radiopacity: radiopaque (X‑ray/CT).
- Prophylaxis: urine acidification.
- Seen in alkaline urine, hyperparathyroidism, type 1 RTA, upper UTI.
- Prevention: hydration, thiazide diuretics, low sodium diet, urine acidification.
5. *Cystine stones* (≈1–2%)
- Crystal: hexagonal‑shaped.
- Radiopacity: weakly radiopaque, possibly staghorn (X‑ray/CT).
- Prophylaxis: urine alkalinization.
- Due to cystinuria (autosomal recessive defect in renal tubular transport).
- Tx: hydration, low sodium diet, urine alkalinization, chelating agents (tiopronin).
6. *Xanthine stones* (≈
