Renal and Ureteric Calculi

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1- Introduction

2- Anatomy and Pathophysiology

3- Causes

4- Treatment 


Renal and ureteric calculi, commonly known as kidney stones and ureter stones respectively, are hard deposits made of minerals and salts that form inside the kidneys and can travel down the ureters.

Types of Stones

  1. Calcium Stones: The most common type, usually in the form of calcium oxalate. Can also form from calcium phosphate.
  2. Struvite Stones: Often related to urinary tract infections. These can grow quickly and become quite large.
  3. Uric Acid Stones: Form in people who lose too much fluid or who eat a high-protein diet. Often associated with gout.
  4. Cystine Stones: Rare, these form in people with a genetic disorder called cystinuria that causes cystine to leak into the urine.
Renal and Ureteric Calculi​

Anatomy and Pathophysiology


  • Location: Located on either side of the spine, just below the rib cage.
  • Function: The kidneys filter blood, remove waste, and produce urine.
  • Formation of Stones: Stones form when urine becomes concentrated, allowing minerals to crystallize and stick together.


  • Structure: Two thin tubes that connect the kidneys to the bladder.
  • Function: Transport urine from the kidneys to the bladder.
  • Stone Passage: Stones formed in the kidney may pass into the ureter, where they can cause significant pain and block urine flow.


  • Location: A muscular sac in the pelvis, just above and behind the pubic bone.
  • Function: Stores urine until it is excreted from the body.
  • Stone Impaction: Stones can move from the ureter to the bladder, where they can either pass out of the body or, rarely, cause obstruction.
© image from snell's clinical anatomy


Causes and Risk Factors

  • Dehydration: Not drinking enough water increases the risk of stone formation.
  • Diet: High intake of protein, sodium, and sugar can increase the risk.
  • Obesity: Increases the risk due to changes in urinary pH.
  • Digestive Diseases and Surgery: Can increase the absorption of stone-forming substances.
  • Family or Personal History: Having a family member with kidney stones increases the risk.
  • Certain Medical Conditions: Conditions such as hyperparathyroidism, certain infections, and metabolic disorders.


  • Hydration: Drinking plenty of water to flush out the urinary system.
  • Medications: Pain relievers, alpha-blockers to relax ureter muscles, and medications to prevent stone formation.
  • Extracorporeal Shock Wave Lithotripsy (ESWL): Uses sound waves to break stones into smaller pieces that can be passed in the urine.
  • Ureteroscopy: A thin scope is inserted through the urethra and bladder to the ureter to remove or break up stones.
  • Percutaneous Nephrolithotomy: Surgical removal of very large stones via a small incision in the back.
  • Parathyroid Surgery: If stones are caused by overactive parathyroid glands.


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