A Review on Pathogenesis, Diagnosis, and Management of Urolithiasis

Review Article

Abstract

Urolithiasis is characterized by the formation of solid mineral deposits within the urinary tract. The condition arises due to interactions between metabolic, environmental, and genetic factors that promote crystal nucleation, growth, and retention. Recent studies indicate rising prevalence rates worldwide, particularly in industrialized nations, with approximately 10% annual recurrence in the first year and up to 75% by 20 years post-initial episode. The pathophysiology involves multiple stages, beginning with urinary supersaturation of stone-forming minerals, followed by crystal nucleation, growth, aggregation, and retention within the renal system. Various intrinsic and extrinsic factors influence stone formation, including urinary pH, hypocitraturia, hyperoxaluria, and hyperuricosuria. The most prevalent stone type remains calcium oxalate (70-80%), followed by calcium phosphate, uric acid, struvite, and cystine stones. Risk factors encompass demographic variables, climate conditions, dietary habits, and comorbid conditions such as obesity, diabetes, and metabolic syndrome. Modern diagnostic techniques incorporate clinical assessment, biochemical analysis, and advanced imaging techniques, enabling precise stone characterization and localization.