Development of a ureteral stone.

Most stones consist of calcium oxalate. In a small percentage of conditions, the stones are composed of uric acid or cystine. Primary hyperparathyroidism accounts for 5% of patients with calculi. Often calcium stone disease occurs in families.

Ureteral stones are noted for causing excruciating pain; this is called renal colic. The pain originates in the flank or kidney area, and radiates the course of the ureter to the genital region and the inner thigh. As the stone passes, the patient experiences fever, chills, hematuria, and urinary frequency. The kidney on the affected side may be temporarily nonfunctioning.

Urinalysis may demonstrate gross or microscopic blood, and the presence of pus. Sediment or stones passed in the urine are evaluated for composition. Most stones are visible on x-ray.

Therapy can prevent patients from forming new stones. A small, single stone occurring without infection or obstructive symptoms does not require treatment. Former open-surgery methods of stone removal have been replaced by endoscopic instrumentation; shock wave lithotripsy (stone crushing by external energy source), or direct vision removal with use of a scope placed in the ureter.

With obstruction relieved, renal function depends on how much irreparable damage was done.

• May be entitled to special monthly compensation where the Veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See 38 CFR 3.350(i)(1) – Special Monthly Compensation (SMC).

• This disease shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits under 38 CFR 3.307 following service in a period of war or following peacetime service on or after January 1, 1947, provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied [38 CFR 3.309 .  [Disease subject to presumptive service connection], 38 CFR 3.309(a) [chronic disease].

• The new criteria for the Genitourinary Disease and Conditions body system became effective November 14, 2021.  Review both current and historic criteria prior to any reduction for disabilities established before that date. 38 CFR 3.951(a)

• When evaluating any claim involving loss or loss of use of one or more creative organs, refer to 38 CFR 3.350 of this chapter to determine whether the Veteran may be entitled to special monthly compensation. Footnotes in the schedule indicate conditions which potentially establish entitlement to special monthly compensation; however, there are other conditions in this section which under certain circumstances also establish entitlement to special monthly compensation.