Patient's question:
Upper pole left ureteral calculus with a diameter of 1.4 cm, accompanied by mild left kidney hydronephrosis. Request: The best and safest treatment plan.Doctor's answer:
Hello: Upper ureteral calculus on the left side, diagnosis confirmed; Generally, kidney stones that fall off into the ureter can be diagnosed as ureteral stones; They often cause ureteral obstruction, leading to renal pelvis dilation and hydronephrosis. If ureteral stones causing obstruction are not removed promptly, it may result in kidney damage and kidney failure. In the early stages, it often presents with lower back pain and discomfort, severe renal colic, causing extreme suffering to the patient. Generally, middle and lower ureteral stones can radiate pain to the penis, testicles, and perineum. Accompanied by symptoms such as nausea and vomiting. It is recommended to use extracorporeal shock wave lithotripsy (ESWL) as the first choice for stone removal treatment; And to start early treatment as soon as possible, as the stone removal effect is better. First, let me explain that extracorporeal shock wave lithotripsy (ESWL) is a non-invasive, new type of stone removal treatment equipment and technology. The principle of ESWL is entirely different from that of extracorporeal shock wave lithotripsy. The advantage of ESWL lies in its lack of any organ damage, thorough stone removal, and minimal pain for the patient, making it easily acceptable. In contrast, extracorporeal shock wave lithotripsy can cause organ damage and is more painful. ESWL technology adopts high-frequency superconducting fluid dynamic shock wave three-dimensional integrated stone removal technology, assisted by large digital ultrasound for positioning. It features accurate positioning, fast stone removal, and complete stone removal from bile duct stones, ureteral stones, allowing them to move out as they are removed, especially effective for in intrahepatic bile ducts. The most prominent feature of this equipment is its user-friendly operability, thorough stone removal for various types of stones, wide range of indications, minimal side effects on the human body, painless stone removal process, generally no need for hospitalization, and low treatment costs, making it easily acceptable to patients. It is a reliable, effective, simple, and practical treatment device with unique equipment and technical advantages. Therefore, it is currently the best choice for treating various types of stones. ESWL is the optimal indication for kidney stones and ureteral stones under 10mm. Generally, after several stone removal treatments, stones can be completely removed. For larger stones, the principle of first crushing and then removing can be adopted to achieve complementary advantages. However, for ureteral stones, it is necessary to wait for 3-5 days after the local ureter becomes congested and edematous before starting stone removal treatment. Generally, stones are relatively easy to remove. Whether it is small ureteral stones or larger multiple stones, due to the widespread use of ultrasound, the diagnosis of ureteral stones is timely and easy. Small stones entering the ureter can generally be detected early, providing the best indication and timing for ESWL stone removal treatment. For stones that have been lodged in the ureter for a long time, it is generally difficult to remove and may require surgical or ureteroscopy procedures. At the same time, it is more important to provide patients with the latest measures for early stone removal treatment, avoiding excessive treatment methods that cause significant organ damage, poor effectiveness, pain, and high costs. The indications and scope of treatment for ESWL are as follows: (1) For various kidney stones and ureteral stones less than 1.2 cm, extracorporeal shock wave lithotripsy should be the first choice for stone removal treatment, as it causes no kidney damage, thorough stone removal, is safe and painless, and has no side effects from shock wave lithotripsy. If the stone diameter is greater than 1.2 cm, extracorporeal shock wave lithotripsy should be used first for crushing, followed by ESWL for thorough stone removal, achieving complementary advantages. (2) This equipment is particularly suitable for acute ureteral stones and the hydronephrosis, renal pelvis dilation, ureteral hydronephrosis, ureteral dilation, and renal colic they cause. It can quickly remove ureteral stones, relieve immediate pain, and rapidly alleviate symptoms. It is currently the preferred treatment for ureteral stones. (3) For patients with multiple kidney stones on the same side combined with ureteral stones, the ureteral stones should be removed first, followed by the removal of multiple kidney stones, to prevent the formation of a "stone street" in the ureter. (4) For large kidney stones that remain in the lower pole of the kidney, renal pelvis, or calyces after ESWL crushing, these small stones are the optimal indication for ESWL for thorough stone removal. This is because the handheld high-frequency superconducting shock wave can directly touch the stones in the lower pole of the kidney, move them into the renal pelvis and ureter, and remove them from the body. (5) For the stone removal treatment of the above various stone diseases, if complications such as urinary tract infections lead to pyelonephritis, ureteritis, cystitis, prostatitis, or urethritis, the stone removal process may be affected due to inflammatory congestion and swelling of the mucosa. Therefore, antibiotic anti-inflammatory treatment must be given first, and ESWL stone removal treatment can only be performed after the inflammation subsides. (6) Generally, 1-3 ESWL stone removal treatments are sufficient to completely remove stones, taking 5-7 days. Patients in good physical condition can undergo continuous stone removal treatments, while those with poorer physical health can have one stone removal treatment every other day. If the patient has poor urinary function or is a carrier of infection, the hospitalization period may be longer. According to clinical observations, Professor Chen Bangjing believes that ESWL is currently the leading new technology for treating stones both domestically and internationally. It is the preferred method for treating kidney stones, ureteral stones (which are generally removed within two hours), gallstones, and extrahepatic bile duct stones, as well as intrahepatic bile duct stones. Its completely thorough stone removal effect, lack of any organ side effects, and low cost have brought benefits to a vast number of patients. For stones beyond the scope of ESWL, extracorporeal shock wave lithotripsy should be performed first, followed by stone removal treatment. For larger kidney cast stones and gallstones, surgical stone removal is recommended as soon as they are detected. If you need treatment, please contact me or communicate online. Thank you for your cooperation.