Prevention and Medical management of urolithiasis-A Review

Dr Chandra Mauli Upadhyay; Dr. Neetish Kumar; Dr. Pravin Kumar

Volume : IX, Issue : VIII, August - 2020

Prevention and Medical management of urolithiasis-A Review

Dr Chandra Mauli Upadhyay, Dr. Neetish Kumar, Dr. Pravin Kumar

Abstract :

Urinary stones are polycrystalline concretions of biominerals occurring in the urinary tract of humans and animals.Their formation is governed by pathoanatomical and physicochemical factors . Around 97% of urinary stones are found in the kidneys and ureters , the remaining 3% in the urinary bladder and urethra .Between 1to15% people globally are affected at some point by urolithiasis in their life time.They occur in one in 11 people at some time in their lifetimes with men affected 2 to 1 over women. Development of the stones is related to decreased urine volume or increased excretion of stone–forming components such as calcium, oxalate, uric acid, cystine, xanthine, and phosphate. Calculi may also be caused by low urinary citrate levels or excessive urinary acidity.Renal calculi present with excruciating pain and most patients present to the emergency department in agony..Nephrolithiasis is a highly prevalent condition with a high recurrence rate that has a large impact on the quality of life of those affected. The recurrence rate ranges from 21% to 53% after 3–5 years. Calcium oxalate (75%–90%) is the most frequent component of calculi, followed by uric acid (5%−20%), calcium phosphate (6%−13%), struvite (2%−15%), apatite (1%) and cystine (0.5%−1%). The incidence of urolithiasis reaches its peak in population aged over 30 years.It also poses a great financial burden on society. There have been great advancements in the surgical treatment of stone disease over the past several decades. The evolution of surgical technique appears to have overshadowed the importance of prevention of stone disease, despite evidence showing medical therapies significantly decreasing stone recurrence rates.