Renal Calculus

1: Epidemiology of Urolithiasis.- I. Early Cases of Vesical Calculus.- II. Ethnic Considerations.- 1. The African Negro.- 2. The American Negro.- III. Climate.- IV. Occupation.- V. Incidence of Stone in Countries with Different Degrees of Economic Development.- 1. Great Britain.- 2. Sweden.- 3. Norway.- 4. Finland.- 5. Czechoslovakia.- 6. Israel.- 7. Turkey.- 8. Sicily.- 9. United States.- 10. India.- 11. Thailand.- VI. The Stone Wave in Central Europe.- References.- 2: Pathology of the Stone-Bearing Kidney.- I. Theories of Renal Stone Formation.- 1. Colloid Material.- 2. Crystals.- 3. Inhibitor Substances.- 4. Calcific Foci.- II. General Structure of Renal Calculi.- 1. Crystalline Content.- 2. Colloid Content.- III. Components of Renal Calculi.- 1. Calcium Oxalate.- 2. Phosphate.- 3. Rare Components.- 4. Matrix Calculi.- IV. Morbid Anatomy.- 1. Infection.- 2. Complications.- References.- 3: Intrarenal, Pararenal and Ureteric Disorders Complicated by Renal Calculi and Calcification.- I. Renal and Ureteric Stone and Obstructive Conditions in the Urinary Tract.- 1. Hydrocalycosis.- 2. Pelviureteric Hydronephrosis.- 3. Retrocaval Ureter.- 4. Horseshoe Kidney.- 5. Ureterocele.- 6. Megaureter.- 7. Ureteric Stricture from Other Causes.- 8. Renal Calyceal Diverticula.- 9. Ureteric Diverticula and Urolithiasis.- 10. Obstruction of the Lower Urinary Tract and Upper Tract Urolithiasis.- II. Renal Calculi and Cystic Conditions of the Kidney.- 1. Pyelogenic Cysts.- 2. Traumatic Cysts.- 3. Polycystic Disease.- 4. Medullary Sponge Kidney.- III. Renal and Ureteric Calculi Associated with Other Congenital Anomalies of the Urinary Tract.- IV. Metaplastic Conditions and Tumours of the Kidney, the Ureter, and Calculi.- 1. Metaplasia (Squamous and Glandular) and Leukoplakia.- 2. Carcinoma of the Renal Parenchyma.- 3. Sarcoma of the Kidney.- 4. Epithelial Tumours of the Renal Pelvis.- 5. Epithelial Tumours of the Ureter.- V. Renal Tubular Acidosis.- 1. In Infants (Lightwood’s Syndrome).- 2. In Adolescents and Adults.- 3. Acetazolamide (Diamox) and Renal Calculi.- VI. Infective Conditions of the Kidney and Calculous Disease.- 1. Renal Tuberculosis.- 2. Renal Actinomycosis.- 3. Typhoid Infections of the Kidney.- 4. Bilharziasis of the Urinary Tract.- 5. Gonococcal Infection of the Kidney.- 6. Renal Brucellosis.- 7. Hyatid Disease of the Kidney.- References.- 4: Some Extrarenal Diseases Associated with Renal Stone or Nephrocalcinosis.- I. Primary Hyperparathyroidism.- 1. Pathology.- 2. Clinical Picture.- 3. Biochemical Diagnosis.- 4. Treatment.- II. Immobilization Osteoporosis and Recumbency Urolithiasis.- 1. Incidence.- 2. Causes.- 3. Special Characteristics.- 4. Treatment.- III. Diseases of Other Ductless Glands.- 1. Cushing’s Syndrome.- 2. Acromegaly.- 3. Multiple Endocrine Adenomatosis.- IV. Sarcoidosis.- V. Paget’s Disease.- VI. Myelomatosis.- VII. Wilson’s Disease.- VIII. Ureterocolic Anastomosis, Ileal Ureterostomy and Cutaneous Ureterostomy.- IX. Renal Calculi Complicating Renal Transplants.- References.- 5: Renal Calculi and Nephrocalcinosis Contributed to by Ingestion of Certain Substances: Environmental Calculosis.- I. Silicate Calculi.- 1. In Man.- 2. In Animals.- II. The Sulphonamides.- III. Renal Papillary Necrosis: Phenacetin Addiction.- 1. Experimental Renal Papillary Necrosis.- 2. Clinical Picture.- 3. Diagnosis.- 4. Treatment.- IV. Nephrolithiasis and Chronic Peptic Ulcer.- 1. Alkalosis from Ingestion of Excess Alkali.- 2. Alkalosis from Simple or Malignant Pyloric Stenosis.- 3. Nephrolithiasis and Peptic Ulcer in the Same Patient.- 4. Milk-drinker’s Syndrome.- V. Chronic Glomerulonephritis and Excessive Ingestion of Milk.- VI. Beryllium Poisoning.- VII. Cadmium Poisoning.- VII. Food Emulsifiers.- References.- 6: Levels of the Principal Crystalloids in the Urine of Patients with Calcium-Containing Calculi.- I. Urinary Calcium.- Relation to Type of Stone.- II. Urinary Phosphate.- III. Urinary Oxalate.- IV. Urinary Crystalluria.- 1. Oxaluria.- 2. Phosphaturia.- References.- 7: Primary Hyperoxaluria and Related Conditions.- I. Primary Hyperoxaluria.- II. Related Conditions.- 1. Vitamin B6 Deficiency.- 2. Hyperoxaluria from Other Causes.- 3. Glycinuria; Hyperglycinemia; Calcium Oxalate Calculi.- References.- 8: Idiopathic Hypercalciuria.- I. Clinical Features and Diagnosis.- 1. Biochemical Findings.- 2. Diagnosis.- II. Pathogenesis.- 1. Renal Tubular Defect.- 2. Intestinal Absorption of Dietary Calcium.- 3. Hyperfunction of Parathyroid Glands.- 4. Summary.- III. Treatment: Measures to Reduce Urinary Calcium.- 1. Diet.- 2. Intake of Fluids.- 3. Specific Measures.- References.- 9: Chemical Substances in Urine Promoting or Preventing Renal Stone.- I. Some Chemical Substances and Their Relation to Renal Stone Formation.- 1. Citric Acid and Citrates.- 2. Urinary Magnesium.- 3. Urinary Sodium and Total Solutes.- 4. Urinary Amino Acids.- 5. Urinary Pyrophosphates and Orthophosphates.- 6. Vitamin D (Calciferol).- II. Inhibitors of Calcification.- 1. Experimental Calcification of Rachitic Rat Cartilage and of Isolated Tendon Bundles.- 2. Urinary Peptides and Crystallization Inhibitors.- 3. Metallic Inhibitors of Crystallization.- References.- 10: Clinical Picture of Renal and Ureteric Calculus.- I. Etiological Factors.- 1. Incidence of Calcium Oxalate Stone.- 2. Age and Sex.- 3. Familial Incidence.- 4. Anatomical Position.- 5. Size of Stone.- II. Clinical Course of Renal Stone Relative to Time.- 1. Duration of Symptoms.- 2. The Single-Stone-Former.- 3. Recurrence.- 4. Bilateral Stones.- III. Clinical Course of Renal Stone and Associated Factors.- IV. Clinical Symptoms of Renal and Ureteric Calculi.- 1. Silent Renal Calculi.- 2. Non-infected Calculi in the Upper Urinary Tract.- 3. Infected Calculi in the Upper Urinary Tract.- 4. Less Common Symptoms of Renal Calculi.- V. Clinical Differential Diagnosis of Renal and Ureteric Calculi.- 1. Acute Pyelonephritis.- 2. Embolism of the Renal Artery.- 3. Extrarenal Syndrome.- VI. Investigation.- 1. Blood Tests.- 2. Urine Tests.- 3. Radiodiagnosis.- 4. Cystoscopic Examination.- 5. Isotope Renography.- VII. Urolithiasis in Children.- VIII. Renal and Ureteric Calculus in Pregnancy.- 1. Clinical Picture.- 2. Treatment.- References.- 11: Some General Considerations in the Surgical Treatment of Renal and Ureteric Stone.- I. Blood Supply of the Kidney.- II. Amount of Renal Tissue Needed to Sustain Life.- III. Compensatory Hypertrophy of the Kidney Following Nephrectomy.- 1. In the Experimental Animal.- 2. In Man.- IV. Recovery of Function After Ureteric Obstruction.- 1. In the Experimental Animal.- 2. In Man.- V. Prevention of Infection.- VI. Temporary Control of Bleeding.- VII. Cooling Techniques.- 1. The Experimental Animal.- 2. In Man.- VIII. Radiography of the Exposed Kidney.- IX. Closure of the Wound.- References.- 12: The Conservative Treatment of Renal and Ureteric Calculi.- I. Conservative Treatment.- 1. Spontaneous Disappearance of Some Renal Calculi.- 2. Spontaneous Voiding of Some Renal and Ureteric Calculi.- 3. Expectant Treatment.- II. Attempted Dissolution of Renal Calculi.- 1. General Considerations.- 2. Irrigation Through an Indwelling Catheter.- 3. Sodium Citrate-Citric Acid Solution: Solution G.- 4. EDTA (Versene).- 5. Renacidin.- 6. Irrigation or Operation?.- 7. Encrusted (Alkaline) Phosphatic Cystitis.- III. Perureteral Instrumental Methods for the Treatment of Ureteric Stone.- 1. General Considerations.- 2. Passage of Ureteric Catheters and Dilators; Indwelling Catheters.- 3. Instruments for Extracting Ureteric Calculi.- 4. Stones in the Intramural Part of the Ureter and at the Ureterovesical Orifice.- 5. Injuries of the Ureter Following Instrumentation.- 6. Ultrasonic Fragmentation of Calculi.- 7. Summary of Results of Instrumental Methods.- References.- 13: Operative Treatment of Renal and Ureteric Calculi.- I. Simple Pyelolithotomy and Its Variants.- 1. For a Calculus in a Mainly Extrarenal Pelvis.- 2. In Situ.- 3. Transparenchymal Extension.- 4. Subcapsular Pyelolithotomy.- 5. Extracapsular Extended Pyelolithotomy.- 6. Conclusion of Operation.- 7. Associated Calyceal Calculi.- 8. Anterior Pyelolithotomy.- 9. Transperitoneal Pyelolithotomy.- 10. Coagulum Pyelolithotomy.- 11. Complications.- II. Nephrolithotomy.- 1. For Calyceal Calculi.- 2. For a Small Solitary Calyceal Stone.- 3. For a Medium-sized Stone in a Dilated Calyx.- 4. For Multiple Small or Medium-sized Calyceal Stones.- 5. The Bivalve Procedure.- 6. Lateral Resection of Renal Tissue.- 7. Complications.- 8. Mortality.- III. Partial Nephrectomy.- 1. For Renal Calculous Disease.- 2. Exposure and Control of Bleeding.- 3. Wedge-Shaped Resection.- 4. Guillotine Method.- 5. Blunt Dissection.- 6. Type of Operation.- 7. Combined Procedures.- 8. Complications.- IV. Ureterolithotomy.- 1. Indications for the Operative Removal of Ureteric Calculi.- 2. Upper Third of the Ureter.- 3. Middle Third of the Ureter.- 4. Lower Third of the Ureter.- 5. Complications.- V. Nephrectomy and Nephroureterectomy.- 1. Indications for Nephrectomy.- 2. Indications for Nephroureterectomy.- 3. Extracapsular Nephrectomy.- 4. Subcapsular Nephrectomy.- 5. Transperitoneal Nephrectomy for Stone.- 6. Nephroureterectomy.- 7. Complications.- VI. Nephrostomy and Pyelostomy for Calculous Pyonephrosis.- 1. Nephrostomy.- 2. Pyelostomy.- References.- 14: Special Groups of Cases of Stone and Their Treatment.- I. Treatment of Bilateral Renal and Ureteric Calculi.- 1. Bilateral Renal Calculi.- 2. Bilateral Ureteric Calculi.- II. Treatment of Stone in a Solitary Kidney.- III. Secondary Operations for Renal and Ureteric Calculi.- 1. Recurrent Renal Calculi.- 2. Recurrent Ureteric Calculi.- IV. Recurrence of Calcium-Containing Stone in the Upper Urinary Tract After Operation.- 1. True and False Recurrence.- 2. Causes of Recurrence.- 3. Incidence of Recurrence in the Author’s Series.- V. Serious Cases of Renal Calculous Disease.- 1. Renal Failure from Advanced Calculous Disease with Pyelonephritis.- 2. Calculous Anuria.- 3. Symptomatic Relief for Patients with Rapidly Recurring Calculi.- VI. Treatment of Infection in the Calculous Urinary Tract.- VII. Medical Treatment of Calcium Phosphate-Containing Calculi.- 1. Aluminium Hydroxide.- 2. Acidogenic Diet and Ammonium Chloride.- VIII. Earlier Non-surgical Measures.- References.- 15: Uric Acid Calculi.- I. Pathology.- 1. Uric Acid Stone.- 2. The Kidney.- II. Clinical Picture.- 1. Uric Acid Calculi and Primary Gout.- 2. Uric Acid Calculi and Secondary Gout.- 3. Idiopathic Uric Acid Calculi Associated with a Family History of Stone.- 4. Uric Acid Calculi Without a History of Gout Nor a Family History of Stone.- 5. Age and Sex Incidence.- 6. Symptoms.- 7. Associated Diseases.- III. Investigation.- 1. Serum Uric Acid.- 2. Urinary Excretion of Uric Acid.- 3. Radiodiagnosis.- 4. Diagnosis.- IV. Treatment.- 1. Surgery.- 2. Conservative Treatment.- 3. Results of Treatment.- 4. Drug Treatment for Gouty Patients.- References.- 16: Cystinuria and Cystine Lithiasis.- I. Incidence of Cystinuria.- II. Cystinuria and Cystine Urolithiasis in Childhood.- III. Pathology.- 1. Cystine Stone.- 2. The Kidney.- IV. Pathogenesis and Genetics of Cystinuria.- 1. Renal Transport Defect.- 2. Intestinal Transport Defect.- 3. Genetic Considerations.- V. Clinical Picture.- 1. Spontaneous Dissolution of Cystine Calculi.- 2. Associated Diseases.- VI. Treatment.- 1. Dietary Measures.- 2. Medicinal Measures.- 3. Surgery.- VII. Cystinuria in Animals.- References.- 17: Xanthine Calculi and Xanthinuria.- I. Xanthinuria and Xanthine Oxidase.- II. Xanthine Stone.- III. Clinical Picture.- IV. Genetic Considerations.- V. Treatment.- References.