Home » Projects » Lithiasis

Obstructive uropathy and nephritic colic

Nephritic colic is severe pain that originates at the height of the kidney or urinary tract due to an acute obstruction in these areas caused by lithiasis (stone or kidney stone).

This obstruction causes urine not to advance along the urinary tract; is held back. This produces an increase in pressure within the urinary tract that is the cause of the pain that accompanies nephritic colic.

Nephritic colic is a fairly frequent problem: in Spain four out of every hundred people manifest this disease, which means about one hundred thousand new cases a year.


In addition to stones, any other element that occupies the ureter and obstructs the kidney can cause colic. This is the case of some tumors that grow inside the ureter or encompass it from neighboring organs such as the intestine, ovary, or

It can also be caused by benign diseases such as retroperitoneal fibrosis or vascular dilations such as aortic aneurysm


It is important not to confuse it with other conditions that have low back pain as a symptom.

Kidney stones can have four origins:

  1. Most stones, between 70 and 80%, contain calcium. They are just as common in men as in women.
  2. Between 20 and 30% of stones are caused by
    urinary tract infections
    (by germs called urea splitters). This type is much more common in women than in men. They are larger stones that usually remain in the kidney.
  3. Between 5 and 10% of kidney stones are produced by uric acid. They are the only ones that can be disposed of with treatment, alkalizing urine. The people who have
    has usually suffered some nephritic colic.
  4. 1% of the stones are due to cystinuria, a disease of genetic origin.


The most important symptom is pain in the lower back, which appears abruptly and intensely.

Usually, this pain radiates to the bladder and genitals, following a downward trajectory although the irradiation depends on the level of the obstruction.

The pain is usually accompanied by nausea, vomiting, and sweating.

Other common symptoms that may occur are:

  • Fever and/or signs of sepsis. Nephritic colic with fever is a VITAL EMERGENCY that should be assessed immediately in the emergency room. Uros Associats has specialists located to attend the Urological Emergencies of Clínica Sagrada Familia and Teknon Medical Center
  • Hematuria: It is the presence of blood in the urine. It may appear in small amounts so it should be detected through urine tests or it may be visible.
  • Dysuria: difficulty or pain of the patient in the evacuation of urine.
  • Pollakiuria: increase in the number of urinations during the day, which are usually of small amount.
  • Anuria: Definitive suspension of urine secretion. This is the sign of greater severity.

The pain may vary in location as the lithiasis progresses in the urinary tract:

  • In renal cramps, the pain is located more intensely in the renal fossa, radiating to the hypochondrium (area of the abdomen located under the diaphragm and floating ribs).
  • In ureteral cramps the pain radiates to the genitals.

Kidney or ureteral stones (the most common cause of colic) produce varying degrees of suffering in the urinary tract, which can be classified depending on the degree of obstruction and the dilation it produces in the system. There are different degrees of dilation, depending on the obstruction:

  • Grade I: slightly dilated renal pelvis without calyx dilation.
  • Grade II: moderately dilated renal pelvis with mild calyx dilation.
  • Grade III: enlarged renal pelvis, dilated calyxes and normal parenchyma.
  • Grade IV: enlarged renal pelvis, dilated calyxes and thinning of the renal parenchyma.


To confirm the disease, the specialist must study if the patient suffers from fever, since this symptom can lead to other clinical pictures that require different approaches.

For clinical diagnosis, the specialist studies the presence, first of all, of the following symptoms :

  • Acute onset abdominal pain.
  • Irradiation to the groin or genitals.
  • The patient does not feel an improvement with rest or changes in posture.

Nausea and vomiting

After this evaluation, the specialist will perform a physical examination that will consist of:

  • An abdominal and lumbar scan
  • A vital signs test.
  • In addition, other tests may be performed, such as blood and urine tests, x-rays of the abdomen, ultrasound and abdominal tomography to detect the location of the stones.

Imaging tests are very useful in diagnosis and guide the specialist on how to manage the pathology. The images also reveal the degree of obstruction caused by lithiasis in the urinary tract.


Treatment should be done as quickly as possible to avoid complications and control pain.

The specialist usually prescribes non-steroidal anti-inflammatory analgesics which are effective against pain and inflammation. In very acute episodes of pain, this can be treated through the application of drugs intramuscularly or intravenously.

It is also usually necessary, in a large number of cases, to administer medications to reduce or eradicate vomiting, in addition to gastric protectors.

If pain management does not respond to analgesics, the specialist will place a ureteral catheter (JJ catheter) to resolve the urinary obstruction and thus control the pain.

In the event that the calculations need to be fragmented to facilitate their elimination, lithotripsy shall be carried out, Medical procedure in which shock waves are used for the decomposition of the stone. Other possible approaches are surgical, almost all endoscopically: ureterorenoscopy, intrarenal retrograde surgery and percutaneous nephrolithotomy, procedures that are indicated depending on the size, location and anatomy of the urinary tract.

At Uros Associats we have an expert team in the management of urinary lithiasis. Our management is multidisciplinary, we have urologists, nephrologist and a specialist in Nutrition for a better control of your disease. . We also focus on prevention, setting regular check-ups in consultation to determine alterations that can be resolved in time, and thus minimize the chances of recurrence or complications. In case the treatment of your stone is necessary we can offer you all the Minimally Invasive techniques available today: EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY (ESWL or LEOC), RIGID OR FLEXIBLE URETEROSCOPY, RETROGRADE INTRARENAL SURGERY (RIRS) AND PERCUTANEOUS SURGERY (PERCUTANEOUS NEPHROLITHOTOMY OR NLP).

Chronic pelvic pain

Chronic pelvic pain is pain that occurs in the area below the navel and between the hips and lasts six months or longer. It can have several causes, and be a symptom of another disease or be a condition in itself.

If chronic pelvic pain seems to be caused by another medical problem, treating that problem may be enough to relieve the pain.

However, many times it is not possible to identify a single cause of this pain. If this is the case, the goal of treatment is to reduce pain and other symptoms and improve quality of life.


Chronic pelvic pain is usually described as follows:

  • Intense, constant pain
  • Pain that comes and goes (intermittent)
  • Stabbing pains or cramps
  • Pressure or heaviness in a deep area of the pelvis
  • Pain during sex
  • Pain with bowel movement or urination
  • Pain when sitting for prolonged periods of time

The discomfort may intensify after standing for long periods and ease when you lie down. The pain can be mild and annoying or it can be so severe that you miss work, can’t sleep, or can’t exercise.


Chronic pelvic pain is a complex condition that can have multiple causes, constituting a symptom of several medical conditions. For example, it is possible for a woman to have endometriosis and interstitial cystitis, both pathologies can cause chronic pelvic pain.

Some of the causes of chronic pelvic pain can be:

  • Endometriosis. This is a condition in which tissue from the lining of the uterus grows outside the uterus. These tissue deposits respond to the menstrual cycle, as does the uterine lining, i.e., thickening, rupturing, and bleeding, as hormone levels rise and fall. Because this takes place outside the uterus, blood and tissue cannot leave the body through the vagina. Instead, they remain in the abdomen, where they can lead to painful cysts and fibrous bands of scar tissue.
  • Musculoskeletal problems. Disorders that affect bones, joints, and connective tissues (musculoskeletal system), such as fibromyalgia, pelvic floor muscle tension, inflammation of the pubic joint (pubic symphysis), or hernias, and can lead to recurrent pelvic pain.
  • Chronic pelvic inflammatory disease. This can happen if a long-term infection, usually sexually transmitted, causes scarring that affects the pelvic organs.
  • Ovarian remains. After surgical removal of the uterus, ovaries, and fallopian tubes, small vestiges of the ovary may accidentally remain, which could then lead to painful cysts.
  • Fibroids. These noncancerous uterine growths can cause pressure or a feeling of heaviness in the lower abdomen. In rare cases, they cause sharp pain.
  • Irritable bowel syndrome. Symptoms associated with irritable bowel syndrome, such as inflammation, constipation, or diarrhea, may be the source of pelvic pain and pressure.
  • Painful bladder syndrome (interstitial cystitis). This condition is associated with recurrent bladder pain and a frequent need to urinate. You may experience pelvic pain as your bladder fills, which may temporarily give way when you urinate.
  • Some doctors believe that dilated varicose veins (varicose veins) around the uterus and ovaries can cause pelvic pain. However, other doctors doubt that pelvic congestion syndrome is the cause of pelvic pain because most women with dilated veins in the pelvis do not have associated pain.
  • Psychological factors. Depression, chronic stress, or a history of sexual or physical abuse can increase the risk of chronic pelvic pain. Emotional distress makes pain worse, and living with chronic pain contributes to emotional suffering. These two factors often create a vicious circle.


Figuring out what’s causing chronic pelvic pain often involves a process of elimination because there are so many disorders that can cause pelvic pain.

In addition to a detailed interview about your pain, your personal medical history and family history, your doctor may ask you to keep a diary of pain and other symptoms.

Tests or exams your doctor may order include:

  • Pelvic exam. It may reveal signs of infection, abnormal growths, or tight pelvic floor muscles. The doctor checks for areas of tenderness. Let your doctor know if you feel any discomfort during this test, especially if the pain is similar to what you’ve been feeling.
  • Laboratory analysis. During the pelvic exam, your doctor may order lab tests to check for infections.
  • Echography. This procedure is especially useful for detecting masses or cysts in the ovaries, uterus, or fallopian tubes.
  • Other imaging tests. Your doctor may recommend abdominal X-rays, computed tomography (CT) scans, or magnetic resonance imaging (MRI) scans to help detect abnormal structures or growths.
  • Laparoscopy. During this surgical procedure, the doctor makes a small incision in your abdomen and inserts a thin tube connected to a small camera (laparoscope). The laparoscope allows the doctor to look at the pelvic organs and check for abnormal tissues or signs of infection. This procedure is especially useful for detecting endometriosis and chronic pelvic inflammatory disease.

Finding the underlying cause of chronic pelvic pain can be a lengthy process and, in some cases, a clear explanation may never be found.

However, with patience and open communication, you and your doctor can develop a treatment plan that will help you live a full life with minimal discomfort.


The goal of treatment is to reduce symptoms and improve quality of life.

If your doctor can determine a specific cause, treatment will focus on that cause. However, if it is not possible to identify a cause, treatment will focus on controlling pain and other symptoms. In many cases, the optimal approach involves a combination of treatments.


  • Analgesics. It is a symptomatic treatment that helps improve the clinic although they do not treat the cause of chronic pain.
  • Hormonal treatments. Some women find that days when they have pelvic pain may coincide with a particular phase of their menstrual cycle and the hormonal changes that control ovulation and menstruation. When this is the case, birth control pills or other hormonal medications can help relieve pelvic pain.
  • Antibiotics. If the source of the pain is an infection, your doctor may prescribe antibiotics.
  • Antidepressants. Some types of antidepressants may be helpful in relieving chronic pain. Tricyclic antidepressants, such as amitriptyline and others, appear to have analgesic and antidepressant effects. They can help improve chronic pelvic pain even in patients who do not have depression.

Other therapies

Your doctor may recommend specific therapies or procedures as part of treatment for chronic pelvic pain. These may include the following:

  • Physiotherapy. Stretching exercises, massage, and other relaxation techniques can improve chronic pelvic pain. A physical therapist can help you with these therapies and develop strategies for coping with pain. Sometimes specific pain points are treated with a medical instrument called transcutaneous electrical nerve stimulation. Transcutaneous electrical nerve stimulation sends electrical impulses to nearby nerve pathways. It may also be helpful to use a psychological technique called biofeedback, which helps you identify areas of tight muscles so you can learn to relax those areas.
  • Neurostimulation (stimulation of the spinal cord). This treatment involves implanting a device that blocks nerve pathways so that the pain signal cannot reach the brain. It may be helpful, depending on the cause of the pelvic pain.
  • Trigger point injections. If your doctor finds specific points where you feel pain, you may benefit from injections of numbing medication into those painful spots (trigger points). The medication, usually a long-acting local anesthetic, can block pain and relieve discomfort.
  • Psychotherapy. If pain may be intertwined with depression, or any type of psychological disorder, you may find it helpful to talk to a psychologist or psychiatrist. There are different types of psychotherapy, such as cognitive behavioral therapy and biofeedback. Regardless of the underlying cause of the pain, psychotherapy can help you develop strategies for dealing with pain.


  • Laparoscopic surgery. If you have endometriosis, your doctor may remove adhesions or endometrial tissue through laparoscopic surgery.
  • Hysterectomy. In rare and complicated cases, your doctor may recommend removing your uterus (hysterectomy), fallopian tubes (salpingectomy), or ovaries (oophorectomy). Undergoing this intervention has significant health consequences. Your doctor will discuss the risks and benefits in detail before recommending this option.
  • Transurethral bladder resection. In some pathologies, such as interstitial cystitis, it is sometimes useful to resect endoscopically the lesions that are in the inner lining of the bladder and that are associated with chronic pain.
  • Intravesical injections. In some cases, the injection of various substances into the mucosa and bladder muscles, such as Botox and some anti-inflammatories, is very decisive. This procedure is performed endoscopically, under anesthesia.
  • Anesthetic block of the nerves of the pelvis. In cases where it is identified that the pain comes specifically from the trigger points where sensitive nerves of the pelvis pass, the doctor may indicate the anesthetic block of these points, which would reduce the painful sensations of that area. Sometimes it is necessary to carry out this procedure in the operating room.

Pain Rehabilitation Program

You may need to try a combination of treatment approaches before you find the best option for you. If applicable, you may need to consider entering a pain rehabilitation program. In Uros Associats we have the support of the Pelvic Floor Rehabilitation section of the Teknon Clinic. They are medical specialists and nurses highly trained in stretching, biofeedback and relaxation-stimulation therapies.


Chronic pain can significantly affect your daily life. When you feel pain, you have trouble sleeping, exercising, or performing physical tasks.

Chronic pain can also cause anxiety and stress, both of which in turn can make pain worse.

Relaxation techniques can help relieve tension, reduce pain, calm emotions, and induce sleep. You can learn many techniques on your own, such as meditation and deep breathing.

Multidisciplinary approach

Depending on the suspected cause of pain, your doctor may refer you to a digestive system specialist (gastroenterologist), gynecology specialist, or musculoskeletal pain specialist (physiatrist or physical therapist).

How to prepare for your appointment

  • Make a list of all the signs and symptoms you’re experiencing. He mentions those that seemed unrelated to the reason for the consultation.
  • Write down key medical information. Include major stressors or recent changes in your life.
  • Make a list of all the medications you take and the dosages you take. Indicate prescription and over-the-counter medications, vitamins or other supplements you’re taking.
  • It’s a good idea to bring a family member or friend. Sometimes it can be difficult to remember all the information provided during a visit. Someone who accompanies you may remember some fact that you forgot or did not notice.
  • Prepare questions. Preparing a list of questions can help you not forget any.

Extracorporeal shock wave lithotripsy (ESWL) unit in Uros Associats

At Uros Associats we have the most modern and effective technology for the non-invasive treatment of kidney stones. Our multifunctional station with digital fluoroscopy Dornier Delta III,


latest generation lithotripter, which guarantees its efficiency and safety.

What is extracorporeal shockwave lithotripsy (ESWL)?

It is a non-invasive procedure that treats renal or ureteral lithiasis through the application of shock waves in liquid medium, which contact the patient through an external device that comes from an electromagnetic source. The shock wave travels uniformly through the liquid medium, but is partially reflected as it passes into a more solid medium (calculation). The reflected wave overlaps the next, so the summative effect substantially increases the pressures inside the calculation. The sum of the waves manages to crack/fragment the lithiasis, in a session of approximately 40 minutes.

A urinary stone is formed by the crystalline aggregation of its mineral components, cohesive together by organic material, in variable quantity according to each type of lithiasis. If the transferred energy (shock wave) is greater than the cohesion forces of the calculation, it fragments into its primary components (crystals). To these effects is added the additional energy produced by the so-called cavitation effect: During the process, microbubbles of air are formed in the liquid medium which undergo a process of compression and subsequent collapse with the formation of microjets that also collaborate to the rupture of the calculus.

A calculation will be easier to fragment with shock waves the more water molecules it contains, since each of them represents an energy transfer point.

For shock waves to be effective in lithotripsy, they must all be concentrated in a single point, which corresponds to the calculation to be treated. To achieve this, a focusing system is required, which generally consists of radiology and ultrasound, which are used independently or combined, according to each type of machine.

Indications for extracorporeal lithotripsy

The maximum effectiveness of the lithotripsy technique is limited to those kidney stones, especially in the pelvis, whose size does not exceed 2 cm in diameter. The universal indications, by consensus, are:

Pielic calculus: More generalized indication of lithotripsy. If the size and consistency are right it can be commonly resolved in a single session. The removal of the fragments is early and generally without incident.

Calicilar lithiasis: it is an indication of lithotripsy from 5 mm in diameter, regardless of the symptoms that may cause.

Ureteral lithiasis: the most current lithotripsy equipment allows the fragmentation of the ureteral calculus without the need for previous catheterization.

Success rate of lithotripsy in the different ureteral locations

After 24 or 48 hours it is common to observe a displacement and even the expulsion of the generated fragments, although this expulsion can be delayed between 2 and 3 weeks after the procedure. The overall effectiveness rate of the procedure will depend on many factors, such as the initial size, edema of the urothelial mucosa, the type of lithiasis and the anatomical morphology of the patient.

Contraindications of lithotripsy

There are some conditions where lithotripsy is discouraged:

  1. Severe kidney infections. Acute pyelonephritis and pionephrosis are circumstances where this procedure should not be performed, due to the risk of worsening the infectious picture and further damaging the state of the organ.
  2. Anatomical alterations of the urinary tract.Although the lithiasis to be treated with lithotripsy is lodged in the renal area, the expulsive process of the fragments generated after it requires an adequate state of the urinary tract. The presence of congenital or acquired stenoses compromises the good outcome of lithotripsy.

-Stenosis of the pyeloureteral ostium.

-Horseshoe kidney.

-Ectopic or transplanted kidney.

-Ureteral anomalies.

  1. Calculations greater than 2cm. In general, these calculations cause obstruction, so it is not advisable to repeat sessions for their resolution.
  2. Calculations very impacted. In ureteral lithiasis, the association of a large calculation, clear signs of impaction and hydronephrosis secondary to it, formally discourages the performance of lithotripsy as a first therapy. The impaction of the stone in the ureteral tract generates local inflammatory phenomena, forming in the first instance an edema of the ureteral wall, followed later by the ulceration of the urothelium that will lead to parietal fibrosis and occasionally the mucosal proliferation that when encompassing the stone will immobilize it definitively. In these cases, the attempt to push the stone up through a catheter is doomed to failure and the practice of lithotripsy will only increase local irritative phenomena and although the calculation could be fragmented and some fragments eliminated, most of it will not progress, maintaining and even increasing, the degree of obstruction. In these cases, the alternative is to perform a laser ureterorenoscopy.
  3. Coraliform lithiasis. The treatment of this type of stones with lithotripsy results in high rates of urinary infection, recurrence of stones and need for second maneuvers. There are other alternatives, percutaneous or endoscopic, to treat this type of lithiasis more safely.
  4. Previous diseases of the kidney that significantly deform its structure: such as renal tuberculosis, organ atrophy, severe hypoplasia, severe chronic interstitial nephropathy.

Adverse effects of lithotripsy

Despite their effectiveness for the fragmentation of lithiasis, shock waves can be harmful to various tissues of the body. The resulting cumulative energy can lead to bruises and bruises on the renal parenchyma and even affect adjacent organs, such as the pancreas and colon. The same process of removal of the fragments constitutes a phase in which various side adverse effects, such as obstructive uropathy (renal colic) and haematuria, may occur. Fortunately with modern equipment these side effects are very rare, and if they occur they are usually transient and mild.

Pain: During lithotripsy, pain may appear in the area where the shock wave transits. That is why our structure has the assistance of anesthesiologists in all treatments, who apply general sedation so that these sensations go unnoticed.

Hematuria: it is a very frequent post-lithotripsy sign, which reflects a renal microtrauma or the passage of fragments when they descend through the urinary tract.

Renal contusion and hematoma: It is a rare complication (0.8%), but it is totally related to the act of lithotripsy. Any patient is subject to the possibility of suffering a renal hematoma after lithotripsy, but this circumstance is especially propitious in hypertensive patients and patients treated with anticoagulants. There are circumstances of the technique that can increase the risk of hematoma: too high applied energy, excessive number of shock waves per session and not respecting a prudential interval between the different lithotripsy sessions, which is estimated at a minimum of 36 to 48 hours.

Obstructive uropathy: The obstruction of the urinary tract by the fragments generated after lithotripsy is a clinical situation that occurs relatively frequently. Usually this situation is transient when the lithiasic fragments are displaced or eliminated, but in 18% of cases an obstructive uropathy can be constituted when these fragments are impacted.

Expulsive phase. The lithiasic street.

Successful lithotripsy generates a multitude of lithiasic fragments from the original calculus. These are of different sizes depending, mainly, on the crystallographic composition of the calculus, although most of them do not exceed 3 mm. Diuresis and the movement of the collecting system and ureter causes the displacement of these fragments towards the bladder, and if this displacement is massive, there is a usually transient obstruction, which occurs with colic pain. The radiological image obtained at this time is very characteristic and shows the agglomeration of calculus fragments taking the shape of its continent: the ureter. This radiological image is called a “lithiasic street”.

The length and thickness of the lithiasic street depends mainly on the size of the treated calculation and/or its composition.

The spontaneous evolution of the “lithiasic street” is the expulsion, although in some cases, given the obstruction it causes, it may require an endoscopic action to be resolved: catheterization and / or ureteroscopy.

Post-lithotripsy protocol

The procedure is performed on an outpatient basis. After a lithotripsy session the patient is transferred to a room, where he is observed for the next few hours. In this period it is identified if any significant immediate complications have taken place. If all is well, during the same day, the patient is discharged with a series of instructions: relative rest for the next 48 hours, abundant fluid intake, analgesic regimen and appointment in consultations with radiological tests.

Subsequent consultations will assess the success of the procedure and determine subsequent follow-up.

Metabolic study of the lithiasic patient

Patients with renal lithiasis require investigations to identify underlying medical conditions and other metabolic abnormalities that predispose them to developing stones. The results of these investigations are used to guide preventive treatment. The depth of the study needed depends on several factors, including the person’s age, medical history, and the number and frequency of stones.

A variety of dietary and metabolic factors can contribute to or cause kidney stone formation. Dietary factors include a high intake of animal protein, oxalate and sodium, and a low intake of fluids and products that inhibit crystal nucleation, such as citrate and potassium.

The metabolic alterations most frequently associated with lithiasis are hypercalciuria, hypocitraturia, gout, hyperoxaluria and hyperuricosuria. Dietary modifications should be applied in all patients with renal lithiasis, and consist of high fluid intake, oxalate and sodium restriction, a balanced diet of animal proteins and supplemented by adequate intake of fruits and vegetables.

When dietary modifications are not sufficient to prevent the formation of lithiasis or in the presence of significant metabolic alterations, specific pharmacological intervention is necessary.

Comprehensive evaluation of the Uros Associats Lithiasis Unit

In our evaluation protocol of the patient with renal lithiasis we include a medical history, physical examination, imaging study and laboratory in blood and urine. Our interest is to identify several factors: number of episodes, frequency of stone formation, age of onset, size of stones, side affected, type of lithiasis, previous urological interventions, presence of concomitant urinary infections, concomitant diseases, habitual medication, family history, occupation, lifestyle and diet.

With these data we achieve a specific objective, which is to determine in the patient the physiological defects that condition their risk of lithiasis, in order to treat it properly and thus change the natural history of this disease. In addition, we make this study as efficient and economical as possible.

The type and extent of the evaluation will depend on: the severity of the disease, whether it is a first episode or a recurrence, the presence or absence of diseases associated with lithiasis and the presence or absence of family history. For example, the latter increases the risk of recurrence 2.6 times, without distinguishing between genetic and environmental factors.

Nutritional and nephrological study of the lithiasic patient

As part of the comprehensive evaluation of the lithiasic patient, we have the multidisciplinary support of specialists in nutrition and nephrology.

Role of the nutritionist

In the nutritional consultation we focus on the patient’s eating habits, emphasizing the daily consumption of liquids and salts. We deliver a nutritional survey at each follow-up and laboratory analysis is carried out periodically.

The nutritional survey applied in our follow-up program aims to detect negative habits and educate the patient. It quantifies the approximate consumption of calcium, the daily consumption and type of liquids ingested daily, the frequency of consumption of animal protein (non-dairy), the periodicity of consumption of fruits and vegetables (to estimate the consumption of citrate and potassium), the approximate intake of sodium and the frequency of consumption of other lithogenic foods (rich in purines and oxalate). This allows us a nutritional management oriented according to the specific alterations investigated in the metabolic evaluation and also in the analysis of the calculation. We instill in our patients certain changes in nutritional habits that must be maintained over time to prevent recurrence, since they are generally chronic conditions.

Role of the nephrologist

At Uros Associats we believe that the nephrologist must actively intervene in the diagnosis, treatment and follow-up of lithiasic patients. Some patients, especially those with nephrocalcinosis or associated parenchymal loss, may develop chronic kidney disease, requiring measures to help preserve kidney function for as long as possible. The nephrologist will help determine the quality of renal fluid and electrolyte management, their acidification capacity, the effect of lithiasis on the glomerular filtration rate of the affected renal unit and the overall functional prognosis of the kidneys.

Likewise, there are certain syndromic medical conditions that are susceptible to medical-pharmacological treatment, and whose control would contribute to the reduction of the frequency of presentation of lithiasic pathology. The specialized management of these drugs is done by the nephrologist.

Commonly used laboratory tests are:

Blood tests:





Uric acid




Vitamin d


Urinary pH



Urine culture

24-hour urine: Harvesting should be done with the patient’s usual diet and physical activity. It is also suggested that samples be collected on an outpatient basis and not during hospitalization. In 24-hour urine is recorded:

Urinary volume: It has been determined that the urinary volume in patients presenting with their first episode of lithiasis is 250 to 350 ml lower than control subjects. In general, a greater urinary volume of 2 to 2.5 liters per day is recommended, without neglecting the intake at night when physiologically the urine is more concentrated.






Potassium – urine

Sodium – urine





In Uros Associats we have specialists of the highest level at national and international level in the treatment of urinary lithiasis, recognized with prizes and awards in different courses and congresses, being innovators in new surgical techniques, and specialists in the medical treatment of urinary lithiasis.