Rigi10™ Malleable Penile Prosthesis
Also Known As
Renal calculi, Nephrolithiasis, Urolithiasis, Urinary stones, Renal stones, Kidney calculi, Nephrolith
Definition
Kidney stones are hard, pebble-like pieces of material that form in one or both kidneys when high levels of certain minerals are in the urine.1 They are mineral deposits in the renal calyces and pelvis that are found free or attached to the renal papillae.2 Kidney stones contain crystalline and organic components and are formed when the urine becomes supersaturated with respect to a mineral.2 Most urinary stones start as Randall plaque at the junction of the nephron’s collecting tubule and the renal pelvis in the papilla.3 Calcium oxalate is the main constituent of most stones, many of which form on a foundation of calcium phosphate called Randall’s plaques, which are present on the renal papillary surface.2 Kidney stones vary in size and shape, ranging from as small as a grain of sand to as large as a golf ball, and are usually yellow or brown in color.1 The scientific name for a kidney stone is renal calculus or nephrolith, and the condition may also be referred to as nephrolithiasis, urolithiasis, or urinary stones.1
Clinical Context
Kidney stone disease is a highly prevalent condition, with rates of up to 14.8% and increasing, and a recurrence rate of up to 50% within the first 5 years of the initial stone episode.2 It affects about 12% of the world population at some stage in their lifetime, with men being affected more frequently than women.4 The most common type of kidney stone is calcium oxalate (70-75% of all urinary stones), followed by calcium phosphate (10%), uric acid (8-10%), struvite (7-8%), and cystine (1-2%).3
The symptoms of kidney stones are related to their location in the kidney, ureter, or urinary bladder.4 Many stones are asymptomatic and discovered incidentally. When symptomatic, the main symptom is pain, which can range from feeling just a little unwell to waves of severe pain.5 Sudden attacks of severe pain on one side, sometimes radiating into the lower abdomen, are common and sometimes referred to as renal colic.5 Other symptoms may include hematuria (blood in urine), painful urination, and a stronger or more frequent urge to urinate.5
Risk factors for stone formation include obesity, diabetes, hypertension, and metabolic syndrome.2 Certain medical conditions increase the risk, including hyperparathyroidism, gout, chronic bowel inflammation, and recurrent urinary tract infections.1 Dietary factors, dehydration, and certain medications can also contribute to stone formation.1
Management of symptomatic kidney stones has evolved from open surgical lithotomy to minimally invasive endourological treatments, leading to a reduction in patient morbidity, improved stone-free rates, and better quality of life.2 Small kidney stones (<5 mm) have a greater chance (90%) of passing on their own with medical expulsion therapy.3 Larger stones may require interventions such as shock wave lithotripsy, ureteroscopy, or percutaneous nephrolithotomy.3 Prevention of recurrence requires behavioral and nutritional interventions, as well as pharmacological treatments specific to the type of stone.2