Nephrolithiasis

Abstract

Renal calculi are usually asymptomatic until urinary obstruction occurs causing flank pain, hematuria, infection, nausea and vomiting. The pain is usually severe and may radiate to the flank, groin, testes or tip of the penis depending on the level of obstruction. Stones occur 3 to 4 times more often in males, are more common in whites than blacks, and usually occur initially between the ages of 30–60 years (70%). In a patient who has passed one stone, the likelihood of passing a second stone is approximately 15% over three years and 50% by 15 years. The average interval between stone events is nine years. The incidence of stones vary geographically and seasonally, with an increased incidence in the Southeastern United States and in the summer when dehydration is more common.