Critical Challenges of Renal Calculi in Women

Stone characteristics, patient factors, and technological features must all be weighted before selecting optimal therapy. A key patient factor is gender. Although renal calculi generally are more frequent in men than in women, the number of women who suffer from urolithiasis has been on the rise in the past 10 years. Calcium and uric acid stones are formed mainly in men; potentially dangerous struvite stones are more common in women. Renal stones in women who are pregnant or even just in their reproductive years can present complex treatment challenges. When examining stone factors, key considerations are the location and size of the stone. For renal calculi smaller than 2cm and located in the upper urinary tract, extracorporeal shock wave lithotripsy (ESWL) is often an effective way to clear the stone, as long as the patient is not pregnant. For larger stones, percutaneous nephrostolithotomy (PNL) may be used to access and fragment the stone using contact (ultrasonic, electrohydraulic, or laser) lithotripsy. For ureteral stones smaller than 5mm that fail to pass spontaneously, ESWL or uteteroscopy can be an effective means to remove them. ESWL and ureteroscopy are currently the principal interventions used in ureteral stone management.