Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e
|Section 10. Renal and Genitourinary Disorders >|
Chapter 97. Urologic Stone Disease
Sections: Epidemiology, Pathophysiology, Clinical Features, Diagnosis, Differential Diagnosis, Treatment, Disposition and Follow-Up, Special Populations/Considerations, Acknowledgments, References.
Topics Discussed: nephrolithiasis; ureterolithiasis; urinary bladder calculi; urinary calculi.
Excerpt:"Urinary calculi are a relatively common condition with an annual
incidence of 0.5% to 1.0% and prevalence in the
U.S. of approximately 5%.1 The lifetime
risk is approximated at 10% to 15% in the U.S.
and other developed countries, with a male predominance of 2:1.2 The
first episode for males occurs at an average age of 30 years, with
a range from 20 to 50 years. After the sixth decade, incidence in
men decreases, and the first occurrence is relatively rare after
age 60. Women develop stones in a bimodal distribution at ages 35
and 55. Unfortunately, urinary calculi recur in 37% of
patients in the first year, 50% of patients within 10 years, and
75% of patients in 20 years.3 Children
<16 years constitute approximately 7% of all renal stone
cases. Unique to children is a 1:1 sex distribution.4 The
most common causes in pediatrics involve metabolic abnormalities
(50%), urologic anomalies (20%), infection (15%),
and immobilization syndrome (5%). The remainder are considered
idiopathic. Ethnically, whites develop stones more frequently than
blacks. Urologic stone disease is relatively rare in Native American
and Asian populations...."
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