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Surgery

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Urology

Question
22 out of 129
 

A 36- year old man presents to the hospital with renal colic. A radiograph reveals a 1.5 cm stone. Which of the following statements regarding this discover is correct?



A Conservative treatment including hydration and analgesics will not result in a satisfactory outcome.

B Serial kidneys-ureters-bladder (KUB) radiographs should be used to follow this patient.

C Urinalysis will nearly always reveal microhematuria

D When the acute event is correctly treated, this disease seldom recurs

Ans. A Conservative treatment including hydration and analgesics will not result in a satisfactory outcome.

(REF. CAMPBELLS UROLOGY 9TH EDITION CHP 44 PG 1275)

a. Approximately 50% to 60% of all solitary renal calculi are less than 10 mm in diameter .

b. Treatment results of SWL for this substantial group of patients are generally satisfactoryand independent of stone location or composition.

c. Although better results can be achieved with PNL or ureteroscopy for patients with stones smaller than 10 mm, these procedures are more invasive, are associated with greater morbidity, and may be reserved for special circumstances .

d. Patients with calculi between 10 and 20 mm are often treated with SWL as first-line management.

e. However, stone composition and location also affect the results of SWL for patients with calculi in this size range and should be carefully considered.

f. Stone composition is also a factor to consider in treatment of patients with stones larger than 10 mm.

g. Cystine calculi respond poorly to SWL treatment, particularly stones larger than 15 to 20 mm .

h. Likewise, brushite calculi have demonstrated an in vitro and in vivo resistance to fragmentation that is surpassed only by cystine calculi .

i. Both PNL and ureteroscopy are less affected by stone location and composition, and good results may be attained with these modalities for patients with 10- to 20-mm renal stones .

Urology Flashcard List

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