Urolithiasis

Urolithiasis (stones within the urinary tract) form a common part of everyday urological practice in the UK, hence a sound understanding of the aetiology, differential diagnosis and initial management is important. Recent advances in imaging technology (in particular non-contrast CT) have significantly changed how stone disease is diagnosed. The management of calculi has also changed, and improvements in endoscopic equipment and techniques mean that open surgery for stones is virtually obsolete. This contribution outlines practice in the UK relating to the presentation of patients with urinary calculi, and discusses which investigations should be considered to confirm the diagnosis. Attention is drawn to the various pitfalls that may be encountered, and the symptoms and signs which should alert the clinician to those cases in which swift intervention could prove highly beneficial in preventing significant morbidity. Also, the various modalities available for the treatment of stone disease are outlined, with a discussion of which interventions are most suited for particular types of stone.