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Ureterolithotomy Workup

  • Author: George M Ghareeb, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
 
Updated: Jul 19, 2015
 

Laboratory Studies

Obtain a complete blood count (CBC), basic metabolic panel (BMP) including BUN and creatinine, as well as a urinalysis and urine culture.

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Imaging Studies

The following imaging studies are recommended:

  • In most cases, a non-contrast CT Abdomen/Pelvis has already been obtained for flank pain evaluation prior to Urology consultation. CT scans reveal the size and location of the ureteral stone, the presence of any other stones, and the presence or absence of associated hydroureteronephrosis or other causes of flank/abdominal pain.
  • Plain radiography (KUB) should be performed following the identification of ureteral stones on CT if medical explusive therapy (MET) is planned. A KUB can show radiopaque stones and are useful for following stones over time. If a radiopaque stone is seen at the time of diagnosis, its presence/movement can be assessed later with repeat KUB. This approach is favored over repeat CT and its associated cost and radiation exposure to the patient. Of course, if the stone is radiolucent (not visible on KUB) then a repeat CT is necessary to follow stone presence/movement over time.
  • Ultrasonography is useful for identifying hydroureteronephrosis, but is not reliable for visualizing stones or their location. Intravenous pyelography (IVP) is now rarely performed.
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Other Tests

An EKG and chest X-Ray are often part of the preoperative anesthesia evaluation and are especially useful in those patients with known cardiopulmonary disease.

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Contributor Information and Disclosures
Author

George M Ghareeb, MD Resident Physician, Department of Urology, University of Iowa Hospitals and Clinics

Disclosure: Nothing to disclose.

Coauthor(s)

James A Brown, MD, FACS Professor of Urology, Residency Program Director, Medical Director, Department of Urology, Professor of Biomedical Engineering, Andersen-Hebbeln Professor of Prostate Cancer Research, University of Iowa, Roy J and Lucille A Carver College of Medicine

James A Brown, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Society for Basic Urologic Research, Society of Laparoendoscopic Surgeons, Society of University Urologists, Society of Urologic Oncology, American Association of Clinical Urologists, Society of Government Service Urologists

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Bradley Fields Schwartz, DO, FACS Professor of Urology, Director, Center for Laparoscopy and Endourology, Department of Surgery, Southern Illinois University School of Medicine

Bradley Fields Schwartz, DO, FACS is a member of the following medical societies: American College of Surgeons, Society of Laparoendoscopic Surgeons, Society of University Urologists, Association of Military Osteopathic Physicians and Surgeons, American Urological Association, Endourological Society

Disclosure: Nothing to disclose.

Additional Contributors

Michael Grasso, III, MD Professor and Vice Chairman, Department of Urology, New York Medical College; Director, Living Related Kidney Transplantation, Westchester Medical Center; Director of Endourology, Lenox Hill Hospital

Michael Grasso, III, MD is a member of the following medical societies: Medical Society of the State of New York, National Kidney Foundation, Society of Laparoendoscopic Surgeons, Societe Internationale d'Urologie (International Society of Urology), American Medical Association, American Urological Association, Endourological Society

Disclosure: Received consulting fee from Karl Storz Endoscopy for consulting.

Jeffrey M Donohoe, MD, FAAP Assistant Professor of Pediatric Urology, Department of Surgery, Division of Urology, Children’s Medical Center, Medical College of Georgia

Jeffrey M Donohoe, MD, FAAP is a member of the following medical societies: American Academy of Pediatrics, American Urological Association

Disclosure: Nothing to disclose.

Sisir Botta, MD Resident Physician, Department of Urology, Medical College of Georgia

Disclosure: Nothing to disclose.

Acknowledgements

Subbarao V Cherukuri, MD Consulting Staff, Department of Urology, St Joseph Regional Health Center

Subbarao V Cherukuri, MD is a member of the following medical societies: American Urological Association and Ohio State Medical Association

Disclosure: Nothing to disclose.

Acknowledgments

Medscape Reference thanks Dennis G Lusaya, MD, Associate Professor II, Department of Surgery (Urology), University of Santo Tomas; Head of Urology Unit, Benavides Cancer Institute, University of Santo Tomas Hospital; Chief of Urologic Oncology, St Luke’s Medical Center Global City, Philippines, for the video contribution to this article.

Medscape Reference also thanks Edgar V Lerma, MD, FACP, FASN, FAHA, Clinical Associate Professor of Medicine, Section of Nephrology, Department of Medicine, University of Illinois at Chicago College of Medicine; Research Director, Internal Medicine Training Program, Advocate Christ Medical Center; Consulting Staff, Associates in Nephrology, SC, for his assistance with the video contribution to this article.

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Laparoscopic ureterolithotomy. Video courtesy of Dennis G Lusaya, MD, and Edgar V Lerma, MD.
 
 
 
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