Ureterolithotomy Workup

Updated: Jan 11, 2021
  • Author: George M Ghareeb, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Workup

Laboratory Studies

Obtain a complete blood count (CBC), basic metabolic panel (BMP), including blood urea nitrogen and creatinine levels, 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 scan 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 ECG and chest radiograph are often part of the preoperative anesthesia evaluation and are especially useful in those patients with known cardiopulmonary disease.

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