Urolithiasis

Urolithiasis, or kidney stone disease, is a condition in which sand or stones form in the urinary system. As the disease progresses, these formations increase in size and can obstruct the flow of urine.

According to the World Health Organization (WHO), 3% of the global population is affected by kidney stones each year. Men are three times more likely to develop urolithiasis than women, with the average age of onset being 40–60 years.

Kidney stones vary in chemical composition (oxalate, urate, protein-based stones) and size (small, medium, large). A separate category is staghorn nephrolithiasis, where stones fill the entire renal calyceal system.

Symptoms indicating the need for diagnosis and treatment

The symptoms of urolithiasis are similar in both men and women. The condition can be recognized by the following clinical signs:

• Dull pain in the lower back, groin, and lower abdomen (which becomes sharp and colicky when the stone moves)
• Hematuria (blood in the urine)
• Painful urination with intermittent urine flow

Diagnostic and treatment methods

Diagnosis

Diagnosis is performed in several stages:

• Laboratory tests of blood and urine (to determine chemical composition)
• Plain and excretory urography (with contrast agent)
• X-ray and multislice computed tomography (MSCT) (to assess the degree of urinary tract dilation)

Treatment

The treatment approach depends on the type, size, and location of the stones.

Conservative treatment (for stones ≤6 mm):

• Medications to dissolve and eliminate stones
• Antispasmodics (to reduce pain) and antibacterial drugs (to prevent infection)
• Diet therapy, designed by a specialist dietitian who is part of a multidisciplinary team for urolithiasis management

Surgical treatment:

• Extracorporeal shock wave lithotripsy (ESWL): a non-invasive shock wave method for stone fragmentation
• Endoscopic lithotripsy (via the urethra): includes ultrasound, pneumatic, and laser stone fragmentation
• Percutaneous nephrolitholapaxy: used for the removal of staghorn stones
• Endoscopic combined intrarenal surgery (ECIRS): applied when stones are present in both the kidney and ureter simultaneously

Innovations in global clinics

Researchers in leading institutions use artificial intelligence (AI) to predict the spontaneous passage of stones from the distal ureter. The AI has a 92% sensitivity for Stone-Free Rate (SFR) when evaluating the effectiveness of surgical treatment.