Calculi are stones that form in an organ or duct of the body. Stones are concretions of materials, usually mineral salts that can cause various important medical conditions.

Though diagnostic workup may vary with the stone type, there are general ways to come up with a diagnosis. In some cases, clinical history and physical examination can be sufficient while others need imaging studies. There are stone types that can only be detected on X-ray and CT scan but many can be detected by ultrasound. Laboratory testing can be conducted to identify contributing factors in the formation of stones. In surgeries, some stones can be directly recovered and sent to a laboratory to analyze its content.

Treatments also vary but generally, modification of predisposing factors can sometimes slow or reverse stone formation. Medications and surgery are needed in some cases. Antibiotics and surgery may be required from infections while medications may be used to manage pain.

Most calculi originate within the kidney and distally proceed. This creates several degrees of urinary obstruction as they become lodged in narrow areas, including the ureteropelvic junction, pelvic brim, and ureterovesical junction. The position of the stone with the urinary tract is attributed to the location and quality of pain. The severity of pain meanwhile is related to the degree of obstruction, presence of ureteral spasm, and presence of any associated infection. Mild to severe deep flank pain without radiation to the groin may be caused by stones obstructing the ureteropelvic junction. This is due to the distension of the renal capsule. Abrupt, severe, colicky pain in the flank and ipsilateral lower abdomen with radiation to the testicles or the vulvar area may be experienced when stones are impacted within the ureter. Stones stuck at the ureterovesical junction meanwhile may also result to irritative voiding symptoms such as urinary frequency and dysuria. Stones that have entered the bladder are usually asymptomatic and are passed somewhat easily during urination. A patient hardly reports positional urinary retention. This may be caused the ball-valve effect of a large stone located at the bladder outlet.

calculi