{
  "schemaVersion": 2,
  "eyebrow": "Urology",
  "title": "Nephrolithiasis",
  "summary": "Manage suspected renal or ureteral calculi by first identifying infected obstruction, renal threat, or uncontrolled symptoms; use noncontrast CT to define actionable anatomy; then select observation, expulsive therapy, ureteroscopy, shock-wave lithotripsy, or recurrence prevention according to stone burden and clinical trajectory.",
  "seoDescription": "Point-of-care approach to nephrolithiasis: emergency triage, CT diagnosis, ureteral stone passage, procedural selection, and recurrent calcium stone prevention.",
  "clinicalQuestion": "How should physicians triage, image, treat, and prevent recurrence in patients with renal and ureteral calculi?",
  "specialty": "Urology",
  "audience": "U.S. physicians and medical trainees",
  "tags": [
    "nephrolithiasis",
    "renal calculi",
    "ureterolithiasis",
    "renal colic",
    "medical expulsive therapy",
    "ureteroscopy",
    "shock-wave lithotripsy"
  ],
  "keyTakeaways": [
    "An obstructing stone with infected urine requires urine testing, empiric antibiotics, intravenous fluid resuscitation, urgent ureteral stent or percutaneous nephrostomy, and deferral of definitive stone treatment. [9]",
    "Noncontrast abdominopelvic CT is the diagnostic reference test for ureterolithiasis and defines stone size, number, and location for treatment selection. [8]",
    "A trial of passage is reasonable for an uncomplicated ureteral stone up to 10 mm when renal function is at baseline, pain is controlled, and infection is absent; reassess if the stone fails to progress during 4 to 6 weeks. [9]",
    "Smaller and more distal ureteral stones are most likely to pass; stones 5 mm or smaller commonly pass spontaneously, whereas stones exceeding 7 mm often require intervention. [8][9]",
    "For recurrent calcium stones despite correction of identified metabolic abnormalities, offer a thiazide diuretic and/or potassium citrate; potassium citrate is a reasonable first option when no risk factor is identified. [7]"
  ],
  "sections": [
    {
      "id": "triage-and-decompression",
      "eyebrow": "Urgent branch",
      "heading": "Identify infected obstruction and renal-threatening presentations",
      "intro": "Decompression decisions precede stone-clearance decisions.",
      "paragraphs": [
        "Treat an obstructive stone with infected urine as a urologic emergency. Obtain urinalysis and urine culture, begin empiric antibiotics and intravenous fluid resuscitation, and arrange urgent drainage with either a ureteral stent or percutaneous nephrostomy tube; intensive care may be required. Defer definitive stone treatment until the infection has been addressed. [9]",
        "Do not continue observation when pain is uncontrolled, renal function is impaired from baseline, obstruction is clinically consequential, or urinary anatomy makes spontaneous passage unlikely. These features exclude the uncomplicated pathway used for medical expulsive therapy and instead warrant urologic intervention planning. [9]"
      ],
      "bullets": [
        "Urgently drain: obstructing stone plus infected urine. [9]",
        "Escalate rather than observe: uncontrolled pain, renal insufficiency, obstruction, or anatomy with low probability of passage. [9]",
        "Delay lithotripsy or definitive extraction until emergency drainage and infection management are complete. [9]"
      ],
      "subsections": [],
      "table": {
        "caption": "Immediate management branch for ureteral stone presentations. [9]",
        "columns": [
          "Clinical state",
          "Immediate action",
          "Definitive next step"
        ],
        "rows": [
          [
            "Obstruction with infected urine",
            "Urinalysis, urine culture, empiric antibiotics, IV fluids, urgent ureteral stent or percutaneous nephrostomy; consider ICU care. [9]",
            "Delay stone treatment until infection is managed. [9]"
          ],
          [
            "No infection, baseline renal function, controlled pain, ureteral stone up to 10 mm",
            "Offer a trial of passage with pain control; consider an alpha-blocker. [9]",
            "Reassess passage and proceed to intervention if the uncomplicated pathway fails. [9]"
          ],
          [
            "Uncontrolled pain, renal insufficiency, obstruction, or unfavorable anatomy",
            "Do not use the uncomplicated observation pathway. [9]",
            "Plan urologic stone intervention. [9]"
          ]
        ]
      }
    },
    {
      "id": "imaging-and-anatomic-risk",
      "eyebrow": "Diagnostic branch",
      "heading": "Define stone anatomy with imaging that changes management",
      "intro": "Size and ureteral location determine the probability of passage and procedural choice.",
      "paragraphs": [
        "Use noncontrast abdominopelvic CT to establish stone size, number, and location when ureterolithiasis is suspected and the result will direct observation versus intervention. CT is described as the diagnostic gold standard, with reported sensitivity of 98%, specificity of 100%, and negative predictive value of 97%. [8]",
        "Use ultrasonography selectively when radiation avoidance or rapid assessment of obstruction is prioritized, but do not treat a negative study as excluding a ureteral stone. In one comparative study, ultrasound identified only 10 of 22 CT-detected ureteral stones (46% sensitivity); another study found lower detection of mid- and distal-ureteral stones and an overall ultrasound sensitivity of 75.4%. [10][11]",
        "If surveillance imaging is needed after a radiopaque stone has been documented, a KUB radiograph may support tracking of passage. A CT scout can occasionally suffice but may lack the necessary detail. [8]"
      ],
      "bullets": [
        "Record CT-measured maximal stone diameter and ureteral location; these are the principal anatomic predictors of spontaneous passage. [8][9]",
        "Interpret a negative ultrasound cautiously for suspected ureteral calculi, particularly in the mid or distal ureter. [10][11]",
        "Use follow-up imaging to document clearance rather than relying on symptom resolution alone when management depends on passage confirmation. [8]"
      ],
      "subsections": [],
      "table": {
        "caption": "Imaging choices for suspected urinary calculi. [8][10][11]",
        "columns": [
          "Modality",
          "Actionable strength",
          "Important limitation"
        ],
        "rows": [
          [
            "Noncontrast CT",
            "Characterizes stone size, number, and location; reported sensitivity 98%, specificity 100%, and negative predictive value 97% for ureterolithiasis. [8]",
            "Uses ionizing radiation. [10]"
          ],
          [
            "Ultrasound",
            "Avoids radiation and can identify hydronephrosis and some renal or ureteral calculi. [10]",
            "Direct ureteral-stone detection is limited; one study reported 46% sensitivity. [10]"
          ],
          [
            "KUB radiograph",
            "Can be used to monitor passage of radiopaque calculi after baseline characterization. [8]",
            "Does not provide CT-level anatomic characterization. [8]"
          ]
        ]
      }
    },
    {
      "id": "trial-of-passage",
      "eyebrow": "Conservative treatment",
      "heading": "Select patients for observation and medical expulsive therapy",
      "intro": "The observation pathway is appropriate only when infection, renal threat, and refractory symptoms are absent.",
      "paragraphs": [
        "Offer a trial of passage for a ureteral stone up to 10 mm only when there are no signs or symptoms of urinary tract infection, renal function is at baseline, and pain is controlled. Smaller stones and distal ureteral location predict a higher likelihood of spontaneous passage and a shorter passage interval. [9]",
        "Use stone size to frame expectations: stones 5 mm or smaller tend to pass spontaneously, whereas stones larger than 7 mm commonly require surgical intervention; stones that have not moved within 4 to 6 weeks should prompt intervention assessment. Stone size does not fully predict symptoms or passage because ureteral anatomy modifies both. [8]",
        "For an uncomplicated trial of passage, provide analgesia and consider an alpha-blocker for 4 to 6 weeks. Evidence summarized in guideline-linked reviews supports increased expulsion and shorter time to passage with alpha-blockers or calcium-channel blockers, while more recent large trials have questioned the magnitude of benefit from tamsulosin; use medication as an adjunct, not as a substitute for reassessment of infection, renal function, pain, or obstruction. [3][5][9]"
      ],
      "bullets": [
        "Eligible for observation: ureteral stone up to 10 mm, no urinary infection, baseline renal function, and controlled pain. [9]",
        "Higher probability of passage: smaller stone and more distal ureteral location. [9]",
        "Reassess at 4 to 6 weeks if the stone has not progressed or passed. [8][9]",
        "Do not infer safe observation from pain severity alone; pain and stone size do not reliably predict one another. [8]"
      ],
      "subsections": [],
      "table": {
        "caption": "Passage-oriented management by anatomic and clinical risk. [8][9]",
        "columns": [
          "Finding",
          "Interpretation",
          "Next action"
        ],
        "rows": [
          [
            "Stone 5 mm or smaller",
            "Often passes spontaneously. [8]",
            "Use the uncomplicated observation pathway if infection is absent, renal function is baseline, and pain is controlled. [9]"
          ],
          [
            "Stone greater than 7 mm",
            "Often requires urologic intervention. [8]",
            "Discuss early procedural management; do not extend observation when clinical complications develop. [8][9]"
          ],
          [
            "No movement after 4 to 6 weeks",
            "Prolonged nonprogression reduces the rationale for continued passage trial. [8][9]",
            "Obtain urologic reassessment for intervention. [8][9]"
          ],
          [
            "Small, distal ureteral stone",
            "Has the most favorable spontaneous-passage profile. [9]",
            "Observation with pain control and optional alpha-blocker is reasonable if otherwise uncomplicated. [9]"
          ]
        ]
      }
    },
    {
      "id": "stone-clearance-procedures",
      "eyebrow": "Definitive treatment",
      "heading": "Choose ureteroscopy or shock-wave lithotripsy when passage is unlikely or unsafe",
      "intro": "Procedure selection depends on anatomy, stone burden, and the need for definitive clearance.",
      "paragraphs": [
        "Ureteroscopy, commonly with laser lithotripsy and basket extraction, and extracorporeal shock-wave lithotripsy are the two commonly used procedures for ureteral stone removal. URS can be used for proximal ureteral stones of any size and produced an 81% overall proximal-ureter stone-free rate in the cited guideline analysis, including rates of 93% for stones smaller than 10 mm and 87% for stones larger than 10 mm. [6][8]",
        "Use SWL when a noninvasive fragmentation strategy is suitable after preprocedure assessment of indications, contraindications, stone localization, and follow-up clearance. SWL guideline recommendations address medication management, prestenting, analgesia or anesthesia, position, energy settings, postprocedure auxiliary therapy, complication management, and clearance evaluation; procedure planning should therefore include a mechanism to confirm fragment clearance rather than assuming treatment success. [2]",
        "For selected very large impacted proximal ureteral stones, percutaneous antegrade removal is an option; the cited guideline specifically identifies stones larger than 15 mm between the ureteropelvic junction and lower border of the sacroiliac joint as a potential indication. [12]"
      ],
      "bullets": [
        "Favor definitive intervention when infection has been controlled but the stone is unlikely to pass, symptoms remain unacceptable, or renal function or obstruction precludes continued observation. [8][9]",
        "URS provides direct extraction or fragmentation and is appropriate for proximal ureteral stones regardless of size. [6][8]",
        "Consider antegrade percutaneous management for selected impacted proximal ureteral stones greater than 15 mm. [12]"
      ],
      "subsections": [],
      "table": {
        "caption": "Procedural options for ureteral stones. [2][6][8][12]",
        "columns": [
          "Procedure",
          "Use case",
          "Key decision point"
        ],
        "rows": [
          [
            "Ureteroscopy with laser lithotripsy and/or basketing",
            "Common definitive treatment; appropriate for proximal ureteral stones of any size. [6][8]",
            "Provides high proximal-ureter stone-free rates in guideline analysis. [6]"
          ],
          [
            "Extracorporeal shock-wave lithotripsy",
            "Noninvasive stone fragmentation option. [2][8]",
            "Plan localization, energy delivery, postprocedure care, and clearance assessment. [2]"
          ],
          [
            "Percutaneous antegrade removal",
            "Selected very large, impacted proximal ureteral stones. [12]",
            "Consider for stones greater than 15 mm in the proximal ureteral segment described by the guideline. [12]"
          ]
        ]
      }
    },
    {
      "id": "recurrence-prevention",
      "eyebrow": "Secondary prevention",
      "heading": "Treat recurrent calcium stone formation after metabolic risk assessment",
      "intro": "Prevention targets persistent stone formation rather than a single acute episode.",
      "paragraphs": [
        "For recurrent calcium stone formers, use metabolic evaluation to identify and address modifiable urinary risk factors, then add pharmacologic prevention when stone formation persists. The AUA guideline recommends offering thiazide diuretics and/or potassium citrate to patients with recurrent calcium stones when other metabolic abnormalities are absent or have been appropriately addressed and stones continue to form. [7]",
        "Potassium citrate can be selected when recurrent calcium stone formation persists despite normal-range urinary citrate or when no specific risk factor is identified; the guideline notes its relatively favorable adverse-effect profile as a reason it may be preferred first-line in patients without identified risk factors. [7]",
        "Use stone composition and clinical pattern to avoid assuming all stones share the same natural history. Calcium oxalate, calcium phosphate, uric acid, and cystine stones may pass spontaneously, whereas struvite stones and staghorn stones rarely pass spontaneously and should not be managed with an expectation of uncomplicated passage. [9]"
      ],
      "bullets": [
        "Indication for drug prevention: recurrent calcium stones with persistent formation after identified metabolic abnormalities have been addressed, or with no demonstrable abnormality. [7]",
        "Drug options: thiazide diuretic and/or potassium citrate. [7]",
        "Do not expect spontaneous clearance of struvite or staghorn stones. [9]"
      ],
      "subsections": [],
      "table": {
        "caption": "Recurrence-prevention decisions for recurrent stone formation. [7][9]",
        "columns": [
          "Clinical pattern",
          "Interpretation",
          "Action"
        ],
        "rows": [
          [
            "Recurrent calcium stones with persistent formation after metabolic abnormalities are addressed",
            "Persistent recurrence justifies pharmacologic prevention. [7]",
            "Offer a thiazide diuretic and/or potassium citrate. [7]"
          ],
          [
            "Recurrent calcium stones without identified risk factors",
            "No specific urinary target is evident. [7]",
            "Potassium citrate may be preferred first-line because of its relatively low side-effect profile. [7]"
          ],
          [
            "Struvite or staghorn stone",
            "Rarely passes spontaneously. [9]",
            "Plan definitive urologic management rather than a passage trial. [9]"
          ]
        ]
      }
    }
  ],
  "faq": [],
  "references": [
    {
      "number": 1,
      "title": "The assessment and management of renal and ureteric ...",
      "detail": "onlinelibrary.wiley.com",
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      "host": "onlinelibrary.wiley.com"
    },
    {
      "number": 2,
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    {
      "number": 3,
      "title": "Medical Expulsive Therapy of Ureteral Calculi and Supportive Therapy After Extracorporeal Shock Wave Lithotripsy - ScienceDirect",
      "detail": "www.sciencedirect.com",
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      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com"
    },
    {
      "number": 4,
      "title": "RANDOMIZED TRIAL OF THE EFFICACY OF TAMSULOSIN, NIFEDIPINE AND PHLOROGLUCINOL IN MEDICAL EXPULSIVE THERAPY FOR DISTAL URETERAL CALCULI - ScienceDirect",
      "detail": "www.sciencedirect.com",
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      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com"
    },
    {
      "number": 5,
      "title": "Medical Treatment for Renal Colic and Stone Expulsion - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/pii/S1569905611000595",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com"
    },
    {
      "number": 6,
      "title": "2007 Guideline for the Management of Ureteral Calculi",
      "detail": "www.auajournals.org",
      "url": "https://www.auajournals.org/doi/10.1016/j.juro.2007.09.107",
      "authors": "www.auajournals.org",
      "host": "www.auajournals.org"
    },
    {
      "number": 7,
      "title": "Medical Management of Kidney Stones: AUA Guideline",
      "detail": "www.auajournals.org",
      "url": "https://www.auajournals.org/doi/10.1016/j.juro.2014.05.006",
      "authors": "www.auajournals.org",
      "host": "www.auajournals.org"
    },
    {
      "number": 8,
      "title": "Ureterolithiasis - StatPearls - NCBI Bookshelf - NIH",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "https://www.ncbi.nlm.nih.gov/books/NBK560674",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov"
    },
    {
      "number": 9,
      "title": "Nephrolithiasis - Endotext - NCBI Bookshelf",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "https://www.ncbi.nlm.nih.gov/books/NBK279069",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov"
    },
    {
      "number": 10,
      "title": "Diagnostic accuracy of ultrasonography compared to unenhanced CT for stone and obstruction in patients with renal failure",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC514525",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov"
    },
    {
      "number": 11,
      "title": "The role of ultrasonography in detecting urinary tract calculi compared to CT scan",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6248231",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov"
    },
    {
      "number": 12,
      "title": "2007 Guideline for the Management of Ureteral Calculi - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S0022534707026092",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com"
    },
    {
      "number": 13,
      "title": "Medical Treatment for Renal Colic and Stone Expulsion",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S1569905611000595",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com"
    }
  ],
  "editorialNote": "Prepared from cited clinical literature using Astra's research workflow. Verify recommendations against current guidance and patient-specific factors.",
  "citations": [
    {
      "number": 1,
      "title": "The assessment and management of renal and ureteric ...",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/tre.710",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com",
      "snippet": "Alpha‐blockers as medical expulsive therapy for ureteral stones. Cochrane ... Medical management to prevent recurrent nephrolithiasis in adults: a.",
      "score": 0.5900477
    },
    {
      "number": 2,
      "title": "International Alliance of Urolithiasis Guideline on Shockwave Lithotripsy - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/pii/S2405456922002632",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Title: International Alliance of Urolithiasis Guideline on Shockwave Lithotripsy - ScienceDirect\nA total of 49 recommendations are summarized and graded, covering the following aspects: indications and contraindications; preoperative patient evaluation; preoperative medication; prestenting; intraope",
      "score": 0.7707586
    },
    {
      "number": 3,
      "title": "Medical Expulsive Therapy of Ureteral Calculi and Supportive Therapy After Extracorporeal Shock Wave Lithotripsy - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S1569905610001569",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Title: Medical Expulsive Therapy of Ureteral Calculi and Supportive Therapy After Extracorporeal Shock Wave Lithotripsy - ScienceDirect\nAccording to the European Association of Urology guidelines, observation as initial treatment is an option for patients with controlled symptoms harboring ureteral ",
      "score": 0.7023877
    },
    {
      "number": 4,
      "title": "RANDOMIZED TRIAL OF THE EFFICACY OF TAMSULOSIN, NIFEDIPINE AND PHLOROGLUCINOL IN MEDICAL EXPULSIVE THERAPY FOR DISTAL URETERAL CALCULI - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/pii/S0022534705600535#!",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Title: RANDOMIZED TRIAL OF THE EFFICACY OF TAMSULOSIN, NIFEDIPINE AND PHLOROGLUCINOL IN MEDICAL EXPULSIVE THERAPY FOR DISTAL URETERAL CALCULI - ScienceDirect\n# Adult Urology: Urolithiasis/Endourology RANDOMIZED TRIAL OF THE EFFICACY OF TAMSULOSIN, NIFEDIPINE AND PHLOROGLUCINOL IN MEDICAL EXPULSIVE T",
      "score": 0.6847074
    },
    {
      "number": 5,
      "title": "Medical Treatment for Renal Colic and Stone Expulsion - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/pii/S1569905611000595",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Title: Medical Treatment for Renal Colic and Stone Expulsion - ScienceDirect\n# Medical Treatment for Renal Colic and Stone Expulsion. Medical expulsion therapy for ureteral stones has been suggested as a method of conservative management of ureteral stones. The aim of this medication is to facilitat",
      "score": 0.6675167
    },
    {
      "number": 6,
      "title": "2007 Guideline for the Management of Ureteral Calculi",
      "detail": "www.auajournals.org",
      "url": "https://www.auajournals.org/doi/10.1016/j.juro.2007.09.107",
      "authors": "www.auajournals.org",
      "host": "www.auajournals.org",
      "snippet": "In 1997, the AUA Nephrolithiasis Clinical Guideline Panel recommended SWL for <1 cm stones in the proximal ureter and either SWL or URS for >1 cm proximal ureteral stones.9 With improved efficacy and reduced morbidity currently associated with ureteroscopic management of proximal ureteral stones, th",
      "score": 0.69274646
    },
    {
      "number": 7,
      "title": "Medical Management of Kidney Stones: AUA Guideline",
      "detail": "www.auajournals.org",
      "url": "https://www.auajournals.org/doi/10.1016/j.juro.2014.05.006",
      "authors": "www.auajournals.org",
      "host": "www.auajournals.org",
      "snippet": "17. Clinicians should offer thiazide diuretics and/or potassium citrate to patients with recurrent calcium stones in whom other metabolic abnormalities are absent or have been appropriately addressed and stone formation persists. (_Standard; Evidence Strength: Grade B_)\n\nThiazides and potassium citr",
      "score": 0.69099766
    },
    {
      "number": 8,
      "title": "Ureterolithiasis - StatPearls - NCBI Bookshelf - NIH",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "https://www.ncbi.nlm.nih.gov/books/NBK560674",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov",
      "snippet": "Stone passage is usually determined by the stone's size, shape, and location, and the patient's ureteral anatomy. While most stones 5 mm and smaller pass spontaneously, stones with a diameter >7 mm and calculi that have not moved in 4 to 6 weeks may need surgical intervention. The 2 procedures most ",
      "score": 0.65279555
    },
    {
      "number": 9,
      "title": "Nephrolithiasis - Endotext - NCBI Bookshelf",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "https://www.ncbi.nlm.nih.gov/books/NBK279069",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov",
      "snippet": "Patients who present with a ureteral stone up to 10mm can be offered a trial of passage if they have no signs or symptoms of urinary tract infection, their renal function is at their baseline, and their pain is well controlled. The likelihood of ureteral stone passage is influenced by stone size and",
      "score": 0.62824833
    },
    {
      "number": 10,
      "title": "Diagnostic accuracy of ultrasonography compared to unenhanced CT for stone and obstruction in patients with renal failure",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC514525",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov",
      "snippet": "## , 59% of patients were males. UHCT identified renal stones in 21 and ureteric stones in 22 patients. Forty-two (98%) of these stones were confirmed clinically (history of spontaneous passage), or during treatment with ureteroscopy, percutaneous nephrolithotomy and extracorporeal shock wave lithot",
      "score": 0.6052631
    },
    {
      "number": 11,
      "title": "The role of ultrasonography in detecting urinary tract calculi compared to CT scan",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6248231",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov",
      "snippet": "### Results\n\nIn 184 patients, NCCT detected 276 (97.2%) stones, while US could identify 213 (75.5%) stones. Overall sensitivity and specificity of US were 75.4% and 16.7%, respectively. Detection rate of mid and distal ureteral stone was lower than that at other locations. The detection rate increas",
      "score": 0.599087
    },
    {
      "number": 12,
      "title": "2007 Guideline for the Management of Ureteral Calculi - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S0022534707026092",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Title: 2007 Guideline for the Management of Ureteral Calculi - ScienceDirect\nSince that time, the Panel has developed three guidelines on the management of nephrolithiasis, the most recent being a 2005 update of the original 1994 *Report on the Management of Staghorn Calculi*.1 The European Associat",
      "score": 0.65914243
    },
    {
      "number": 13,
      "title": "Medical Treatment for Renal Colic and Stone Expulsion",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S1569905611000595",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "An additional aim of the urologist is to overcome the obstruction and to preserve renal function. Medical expulsion therapy for ureteral stones has been suggested as a method of conservative management of ureteral stones. The aim of this medication is to facilitate the passage of ureteral stones, an",
      "score": 0.5533369
    }
  ],
  "publishedAt": "2026-08-24T16:18:19.283941+00:00",
  "updatedAt": "2026-08-24T16:18:19.283941+00:00",
  "readingMinutes": 5,
  "slug": "nephrolithiasis"
}