URINARY STONE DISEASE - A PRACTICAL GUIDE TO METABOLIC EVALUATION

Urolithiasis is the third most common affliction of the urinary tract, after infections and diseases of the prostate. Approximately 10% of t he North American population will have at least one urinary calculus b y, age 70. A thorough history and physical examination will usually co nfirm the diagnosis of urinary stone disease. A simplified laboratory evaluation may be performed for patients with a single stone episode. A more extensive evaluation is required for patients with recurrent, m etabolically active stones and patients at high risk (ie, cystine ston e formers and those who develop bladder dysfunction or nephrosclerosis ). Intravenous pyelography with tomography remains the gold standard f or imaging of the urinary tract to confirm the diagnosis and formulate a treatment plan.