Which are the symptoms?
The widespread use of ultrasound in urinary calculosis makes it possible to diagnose the disease at a completely asymptomatic stage. The initial clinical manifestation of nephrolithiasis is renal colic or renal-ureteral colic, which results from obstruction of the urinary tract. The main symptom is persistent colic pain, first in the side and then irradiating to the groin. The pain may be accompanied by nausea and vomiting. Kidney stones may also be associated with changes in urinalysis, such as typically the presence of blood in the urine, sometimes to the extent of macrohaematuria.
How is it diagnosed?
Ultrasonography remains the first level diagnostic method and can detect indirect or direct signs of urinary tract stones. Combination with abdominal radiography increases its accuracy and can also add important information about whether the stone is radiopaque or not. However, the most accurate examination is a CT scan (even at low intensity of radiation), which may be necessary to establish the diagnosis.
How is it treated?
The prevention of recurrent kidney stone disease is based on an appropriately specialised approach that seeks to identify dietary factors and changes in urine composition that may lead to the formation of kidney stones. The need for drug therapy is then determined and an appropriate diet is prescribed to prevent stone formation. In the case of renal colic, it may be necessary to administer painkillers to help the stones to recede. The use of antibiotics may be necessary if there are infectious complications in the urinary tract. A variety of surgical treatments (shockwave lithotripsy, endoscopic or translombar treatment) are used to remove stones from the urinary tract, depending on the size, location and type of stone.