28 (3):325-9. Ureteral stone with hydronephrosis and urolithiasis alone are - Nature Author disclosure: No relevant financial affiliations. In the Swiss Lithoclast, for example, one probe is a pneumatic lithotripter and the other is an ultrasonic lithotripter. Nephrolithiasis specifically refers to calculi in the kidneys, but renal calculi and ureteral calculi (ureterolithiasis) are often discussed in conjunction (see the images below). No IV contrast necessary, so no risk of nephrotoxicity or acute allergic reactions, With only rare exceptions, shows all stones clearly, Can be performed in patients with significant azotemia and severe contrast allergies who cannot tolerate IV contrast studies, Shows perinephric stranding or streaking not visible on IVP and can be used as an indirect or secondary sign of ureteral obstruction, No radiologist needs to be physically present, Preferred imaging modality for acute renal colic in most EDs, Without hydronephrosis, cannot reliably distinguish between distal ureteral stones and pelvic calcifications or phleboliths, No nephrogram effect study to help identify obstruction, Unable to identify ureteral kinks, strictures, or tortuousities, May be hard to differentiate an extrarenal pelvis from true hydronephrosis, Gonadal vein sometimes can be confused with the ureter, Does not indicate likelihood of fluoroscopic visualization of the stone, which is essential information in planning possible surgical interventions, Cannot be performed during pregnancy because of high dose of ionizing radiation exposure, Usually more costly than an IVP in most institutions, Clear outline of complete urinary system without any gaps, Clearly shows all stones either directly or indirectly as an obstruction, Nephrogram effect film indicates obstruction and ureteral blockage in most cases, even if the stone itself might not be visible, Ureteral kinks, strictures, and tortuousities often visible, Can modify study with extra views (eg, posterior oblique positions, prone views) to better visualize questionable areas, Stone size, shape, surgical orientation, and relative position more clearly defined, Orientation similar to urologists surgical approach, Limited IVP study can be considered in selected cases during pregnancy, although plain ultrasonography is preferred initially, Lower cost than CT scan in most institutions, Relatively slow; may need multiple delay films, which can take hours, Cannot be used in azotemia, pregnancy, or known significant allergy to intravenous contrast agents, Risk of potentially dangerous reactions to IV contrast material, Cannot detect perinephric stranding or streaking, which is visible only on CT scans, Harder to visualize radiolucent stones (eg, uric acid), although indirect signs of obstruction are apparent, Presence of a radiologist generally necessary, which can cause extra delay, Cannot be used to reliably evaluate other potential pathologies. 59(6):835-8. Larger stones (ie, 7 mm) that are unlikely to pass spontaneously require some type of surgical procedure. J Endourol. Complete staghorn calculus that fills the collecting system of the kidney (no intravenous contrast material in this patient).
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