Symptoms in ureteric calculi
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ureteric calculi symptoms clinical features presentation
Bailey and Love's Short Practice of Surgery 28th Edition
Page 1496
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ureteric calculi stone locations symptoms diagram
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Symptoms of Ureteric Calculi
(Bailey & Love's Short Practice of Surgery, 28th Ed., p. 1496)
1. Pain (Ureteric/Renal Colic)
The hallmark symptom. Caused by hyperperistalsis of ureteric musculature against the obstructing stone.
| Feature | Detail |
|---|---|
| Onset | Sudden, without warning |
| Character | Excruciating, colicky |
| Location | Flank / loin |
| Radiation | Groin, scrotum (males), labia (females) |
| Severity | One of the most severe pains known |
Pain location shifts as the stone descends the ureter — upper ureteric stones → loin to groin radiation; lower ureteric stones (near VUJ) → radiation to tip of penis/labia, with bladder symptoms.
2. Urinary Symptoms
- Haematuria — gross (visible) or microscopic; especially during colic episodes
- Urgency & Frequency — particularly with stones at or near the vesico-ureteric junction (VUJ)
- Calculuria — passage of sand, gravel, or small stones in the urine
3. Systemic Symptoms
- Nausea and vomiting — common during acute colic
- Fever with chills/rigors — suggests underlying urinary tract infection (UTI) complicating obstruction; constitutes a urological emergency
- Malaise and weight loss — seen with longstanding infection stones or renal failure
4. Asymptomatic Presentation
- Stones may be incidentally detected on imaging done for other reasons — increasingly common with widespread use of CT and ultrasound.
CT KUB Showing Urolithiasis at Various Levels
Symptom Summary by Stone Location
| Stone Location | Predominant Symptoms |
|---|---|
| Upper ureter / PUJ | Severe loin pain, flank tenderness |
| Mid-ureter | Pain radiating to iliac fossa |
| Lower ureter (VUJ) | Frequency, urgency, dysuria, radiation to tip of penis/labia |
Red Flag Symptoms (Require Urgent Management)
- Fever + rigors (infected obstructed system — emergency decompression needed)
- Anuria/oliguria (bilateral obstruction or obstruction of single functioning kidney)
- Uncontrolled pain or vomiting
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