Sometimes there's a lot of ways to say the same thing. So when you're talking about renal

or ureteral stones or nephrolathiasis or ureteral calculi or kidney calculi, you're often just talking

about stone disease even though clearly if you say uretero calculi

you're more in the ureter so that is a bit more specific but really what we're

talking about is calculi calculate are stones and stones form from crystals that

precipitate out into the urine.

And the reason that these stones form in the urinary tract is these crystal-forming substances,

so we're usually talking about calcium or oxalate or uric acid, is high in the urine.

Or perhaps it's something that inhibits stone formation that is low in the urine, particularly something like citrate being low. And if you have something

that predisposes to one of those situations, whether it's a medical condition or poor fluid intake or certain dietary

habits, you are going to be more prone to forming stones. And that's really important because

you want to try and change whatever dietary issue, medication, underlying medical problem is causing these stones because there is a

high recurrence that if you have stones once, you're at high risk for having them again. So you

want to try and prevent that from happening. Because as we all know, history can repeat itself,

although not for everything, meaning I don't think the dinosaurs

are coming back. I don't know. I might even be wrong about that. Jurassic Park was kind of convincing.

So anyway, when we see stones and you're going to see stone disease, calculate both in the

inpatient and the outpatient setting, there is a lot to consider. And I think the first

thing, the biggest consideration is, is this a septic patient? Is this patient infected? Because if you're

septic with an obstructing stone, you have got to get that stone out of there. Or maybe more accurately, I should say,

you at least have to decompress the collecting system,

meaning if the stone's obstructing in your septic,

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