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11 Oktober 2010

Learning Series Urology: Urinary Tract Stones

| 11 Oktober 2010 | 0 komentar

DIAGNOSIS

Anamnesis
Patients with urinary tract stones have a complaint that vary from without complaint, mild back pain with colic, dysuria, hematuria, urinary retention, anuria. These complaints may be accompanied by complications include fever, signs of kidney failure.

PHYSICAL EXAMINATION
Physical examination of patients with urinary tract stones can vary from no physical abnormalities until signs of severe illness depending on the location of the stones and complications caused.
A general physical examination: hypertension, febrile, anemia, shock
Urology specific physical examination
o Angle kosto vertebrae: tender, painful word of the kidney, renal enlargement
o Supra symphysis: tender, palpable stone, full jar
o External Genitalia: palpable stone in the urethra
o Plug Anal: palpable stone in the bladder (bimanual palpation)

LABORATORY EXAMINATION
Routine urine tests to see eritrosituri, lekosituria, bacteriuria (nitrite), pH of urine and urine culture. Blood tests in the form of hemoglobin, leukocyte, urea and creatinine.

IMAGE
Clinical diagnosis should be supported by appropriate imaging procedures.
Routine examination included a plain photo abdomen (KUB) and ultrasonography or intravenous pyelography (IVP) or spiral CT.1, 2.3 IVP examination should not be performed in patients with the following:
• By contrast media allergy
• With serum creatinine levels> 200╬╝mol / L (> 2mg/dl)
• In the treatment metformin
• With myelomatosis

Special examination could involve:
• retrograde or antegrade pyelography
• Scintigraphy

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