Urolithiasis Pathogenesis Risk Factors and Modern Treatment Approaches
Keywords:
Urolithiasis, Kidney stones, Pathogenesis, Risk factors, Minimally invasive treatmentAbstract
Urolithiasis, a prevalent urological disorder, is characterized by the formation of stones within the urinary tract due to supersaturation, crystallization, and aggregation of minerals. This review explores the epidemiology, pathogenesis, classification, risk factors, and management strategies for urinary stone disease. Genetic predisposition, metabolic disorders, dietary influences, urinary tract infections, and gut microbiota alterations contribute to stone formation. Calcium-based stones, particularly calcium oxalate, are the most common, followed by uric acid, struvite, cystine, and drug-induced stones. Diagnosis relies on clinical symptoms, urinalysis, biochemical evaluations, and imaging techniques such as computed tomography. Management approaches vary depending on stone size, composition, and location. Conservative strategies include pain control and medical expulsive therapy with alpha-blockers. Pharmacological interventions such as citrate supplements, urate-lowering agents, and thiazide diuretics help prevent recurrence. Minimally invasive procedures, including extracorporeal shock wave lithotripsy and ureteroscopy with laser lithotripsy, are effective for small to medium stones, while percutaneous nephrolithotomy is preferred for larger or complex calculi. Surgical interventions are reserved for refractory cases. Advances in precision medicine, microbiome research, and metabolic risk assessment may improve prevention and treatment. Future studies should focus on personalized therapeutic strategies to reduce recurrence rates and improve patient outcomes.
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