A. DIFFERENTIAL DIAGNOSIS
Urinary stones can mimic other retroperitoneal and peritoneal pathologic states.  A full differential diagnosis of the acute abdomen should be made, including acute appendicitis, ectopic and unrecognized pregnancies, ovarian pathologic conditions including twisted ovarian cysts, diverticular disease,  bowel obstruction,  biliary stones with and without obstruction, peptic ulcer disease, acute…    



Urinary Stone Disease Intervention

A. CONSERVATIVE OBSERVATION
Most ureteral calculi pass and do not require intervention.

Spontaneous passage depends on stone size,  shape,  location,  and associated ureteral edema (which is likely to depend on the length of time that a stone has not progressed). Ureteral calculi 4–5 mm in size have a 40–50% chance of spontaneous…    



Urinary Stone Disease Prevention

In general,  50%  of patients experience recurrent urinary stones within 5 years without prophylactic intervention.

Appropriate education and preventive measures are best instituted with a motivated patient after spontaneous stone passage or surgical stone removal. Risk factors as described previously should be identified and modified, if possible.

Irrespective of the final metabolic evaluation…    



Prostatic & Seminal Vesicle Stones

Prostatic calculi are found within the prostate gland per se and are found uncommonly within the prostatic urethra.

They are thought to represent calcified corpora amylacea and are rarely found in boys. Usually small and numerous, they are noted to be tannish gray in color during transurethral resection of the prostate.  They are commonly…