Asymptomatic kidney stones are found
during the workup for unrelated conditions. These stones are
usually in the kidney and causing no obstruction.
Kidney stones that obstruct are the ones that cause pain,
which is the most common presenting symptom. This pain may
be in the flank with radiation into the lower abdomen and
inguinal areas as well as to the testicle in males and the
labia in females. Stone
pain or renal colic can vary from a mild ache to
the worst pain imaginable. Women often describe it as worse
than labor pain, and patients often say there is no position
which gives relief of pain.
Hematuria, or blood in the urine, occurs in 95% of the cases.
This may be gross hematuria, visible to the eye, or microscopic,
detected by a urine dip stick or microscopic exam.
Nausea and vomiting are common, and patients may present
in a dehydrated state.
Once a kidney stone reaches the ureterovesical junction where
the ureter drains into the bladder, patients often experience
frequency, urgency, and burning with urination or dysuria.
Sometimes a stone in this location can be confused with urinary
tract infection which may have the same symptoms.
If fever is present, one has to suspect urinary tract infection,
which if combined with kidney stone obstruction may lead to
serious consequences.
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