Treatment Plan
Treatment Plan
Admission criteria:
- Gunshot diagnosis
- Dehydration
- Risk of AKI
- Shock
- Systemic infection signs
Medical management:
- NSAIDs (primarily diclofenac) for pain relief
- Stones <5mm: watchful waiting
- Stones ≤10mm: medical expulsion therapy with alpha-blockers
Surgical options:
- Shock wave lithotripsy
- Nephrolithotomy
- Ureteroscopy
- Open surgery if the above fail
Prevention:
- Increased fluid intake
- Reduced calcium intake
- Reduced salt intake (max 6g/day)
- Balanced diet
- Potassium citrate for calcium oxalate stones
- Thiazide diuretics for calcium oxalate stones with hypercalciuria
Prognosis
High recurrence rates