Clinical Presentation
Urolithiasis_Initial Assesment 1
The hallmark of obstruction in the ureter and renal pelvis is the sudden onset of excruciating, intermittent pain that radiates from the flank to the groin or to the genital area and inner thigh. Patient with ureteral stones may also present with vomiting and fever. Lower urinary tract symptoms associated with urolithiasis are urgency, frequency, urge incontinence, dysuria, and hematuria (gross or microscopic).
History
A detailed history from the patient should be elicited. A thorough review of medical records should include the number and frequency of episodes and previous imaging studies, interventions, evaluations, and treatments. Family history may reveal genetic predisposition and dietary history should also be obtained. A complete list of current prescription and over-the-counter drugs, as well as vitamins and supplements, should be obtained.
Physical Examination
Urolithiasis_Initial Assesment 2
The physical examination should include weight, blood pressure, costovertebral angle tenderness, and lower extremity edema, as well as signs of primary hyperparathyroidism and gout in the assessment.