HTHSCI 2F03 Lecture Notes - Lecture 15: Pelvic Brim, Calcium Oxalate, Hematuria

• School: McMaster University
• Department: Health Sciences
• Course: HTHSCI 2F03
• Professor: Bruce Wainman

Document Summary

Crossing the iliac vessels at the pelvic brim. Severe loin pain radiating to the groin. Suprapubic pain radiating tip of penis or in labia. Pain and haematuria worse at the end of micturition. Urate stones are radiolucent, cysteine stones are faint. Iv contrast injected and control, immediate and serial films taken until contrast @ level of obstruction. Delayed, dense nephrogram: no flow from kidney. Fluids: iv if unable to tolerate po. Abx if infection: e. g cefuroxime 1. 5mg iv tds. Sieve urine to collect stone for opd analysis. Most pass w/i 48h, 80% w/i 30d. Low likelihood of spontaneous passage: e. g. >10mm. Stones <20mm in kidney or proximal ureter. Stone >10mm in distal ureter or if swl failed. Invasion of l renal vein varicocele (1%) Robson staging: confined to kidney, involves perinephric fat, but not garota"s fascia, spread into renal vein, spread to adjacent / distant organs. Consider partial if small tumour or 1 kidney.