disease is the cause of significant morbidity in our society. It
is estimated that approximately 12% of the population will have
a renal stone at some point in their lives. In the United States
and other industrialized countries, kidney stones are more common
in men than in women. Twelve percent of men and 5% of women will
suffer from renal stones by the age of 70 years. Patients with a
history of stones, have a 50% risk of developing another stone within
5-10 years. Moreover, in selected patients, repeat stone formation
rates may approach 80% over their lifetime. In addition, calculi
are more common in white patients than in Afro-Americans. The prevalence
of urinary calculi increases with age, attaining a maximum in the
40 - 60 year category among white patients and somewhat later in
non-white patients. After the age of 60, the prevalence decreases
and approaches 0 by the ninth decade of life. The incidence of renal
stones varies between countries.
calculi in children and adolescents occur less commonly than in
adults. Stones in the pediatric population are usually idiopathic
or related to inborn errors of metabolism, congenital urologic anomalies
or immobilization. Climate is also a factor, which effects the incidence
of renal calculi. Kidney stones are more frequently seen in warmer
climates and during the summer months. This may be due to dehydration
with excretion of lower than usual volumes and increased concentration
mechanisms of stone formation also vary from country to country.
In western cultures, for example, dietary plentitude contributes
to stone formation. In the mid-east, schistosomiasis is a frequent
cause of urinary stone disease.
the management of renal stones, there is an explosion in technical
innovations. Today, the endourologist possesses an assortment of
minimally invasive tools to treat renal stones. Most patients may
receive fast, safe and effective treatment in the outpatient setting.
However, despite the many technical advances, anatomical malformations
of the urinary tract and complex stones continue to provide a significant
challenge to the urologist. This website will highlight the different
types of renal calculi a urologist is likely to encounter in his
or her practice and the various treatment options for kidney, ureteral
and bladder stones. In addition, potential difficulties with diagnosis,
access of a stone, its fragmentation and clearance will be discussed.
Finally, a variety of urinary stone presentations and treatment
strategies for cost-effective management are addressed.