Patient's question:
Today it was found that there is a stone in the upper part of the left ureter accompanied by hydronephrosis of the left kidney. The upper part of the left ureter is dilated by 1.2 cm, and an echo spot about 0.8 cm in size can be seen.Doctor's answer:
Hello: Left renal calculus combined with left ureteral calculus is relatively common clinically, and it can be clearly diagnosed through B examination. Generally, when multiple renal calculi shed into the ureter, it can be diagnosed as ureteral calculus. It often causes ureteral obstruction, leading to renal pelvis dilation and hydronephrosis. It typically presents with lower back pain, discomfort, and renal colic. Middle and lower ureteral calculi can radiate pain to the penis, testicles, and perineum. Accompanied by symptoms such as nausea and vomiting. It is recommended to use the first choice - extracorporeal shock wave lithotripsy (ESWL) for calculus removal treatment. And start early treatment as soon as possible, which has a better effect on calculus removal.First, let me explain that the principle of extracorporeal shock wave lithotripsy (ESWL) is fundamentally different from extracorporeal shock wave lithotripsy. The advantage of ESWL lies in its lack of organ damage, thorough calculus removal, and minimal pain for patients, making it easily acceptable. In contrast, extracorporeal shock wave lithotripsy causes organ damage and is more painful.
The technology of extracorporeal shock wave lithotripsy adopts a high-frequency superconducting fluid dynamic shock wave three-dimensional integrated calculus removal technology, assisted by large digital B-ultrasound for positioning. It features accurate positioning, fast calculus removal, and is effective for bile duct calculi, ureteral calculi, allowing them to be removed as they move. Especially for intrahepatic biliary calculi, it achieves thorough removal. The most prominent feature of this equipment is its humanized operability, thorough calculus removal for various types, wide applicability, almost no side effects on the human body, painless removal process, generally no need for hospitalization, and low treatment costs, making it easily acceptable for patients. It is a reliable, effective, simple, and practical treatment device with unique equipment and technical advantages. Therefore, it is the best choice for treating various types of calculi.
For the treatment of renal calculi less than 10mm combined with ureteral calculi using ESWL, it is necessary to first remove the ureteral calculus before treating the renal calculus. Generally, after several treatment sessions, the calculi can be removed. For larger calculi, the principle of first crushing and then removing can be adopted to achieve complementary advantages. However, for ureteral calculi, treatment should be delayed for 3-5 days until local ureteral congestion and edema subside before removal. Generally, calculi are relatively easy to remove.
Whether it is small ureteral calculi or larger multiple renal calculi, due to the widespread use of B-ultrasound, the diagnosis of ureteral calculi is timely and easy. Small calculi entering the ureter are generally detected early, providing the best conditions and timing for ESWL treatment. For calculi that have been lodged in the ureter for a long time, removal is difficult and may require surgical or ureteroscopy procedures. At the same time, it is more important to provide patients with the latest measures for early calculus removal, avoiding excessive treatment methods that cause significant organ damage, poor efficacy, pain, and high cost.
The indications and treatment scope of extracorporeal shock wave lithotripsy are as follows:
(1) For renal calculi and ureteral calculi less than 1.2cm, ESWL should be the first choice for calculus removal. It has no kidney damage, thorough removal, safety, and no side effects from shock wave lithotripsy. If the calculus diameter is greater than 1.2cm, extracorporeal shock wave lithotripsy should be used first for crushing, followed by ESWL for thorough removal, achieving complementary advantages.
(2) This equipment is particularly suitable for acute ureteral calculi and the resulting renal pelvis hydronephrosis, renal pelvis dilation, ureteral hydronephrosis, ureteral dilation, and renal colic. It can quickly remove ureteral calculi, alleviate pain immediately, and rapidly relieve symptoms, making it the preferred treatment for ureteral calculi.
(3) For patients with multiple renal calculi combined with contralateral ureteral calculi, the ureteral calculus should be removed first, followed by the removal of multiple renal calculi, to prevent the formation of a "stone street" in the ureter.
(4) For large renal calculi treated with ESWL, the small calculi remaining in the lower pole of the kidney, renal pelvis, and calyces are the best indication for ESWL for thorough removal. This is because the handheld high-frequency superconducting shock wave probe can directly touch the lower pole renal calculus, moving it into the renal pelvis and ureter for removal.
(5) For the calculus removal treatment of the above various types of calculi, due to complications such as urinary tract infections leading to pyelonephritis, ureteritis, cystitis, prostatitis, urethritis, as well as infections of the liver and biliary system leading to cholecystitis and intrahepatic or extrahepatic cholangitis, the inflammatory congestion and swelling of the mucosa can affect calculus removal. Therefore, antibiotic anti-inflammatory treatment must be administered first, and ESWL treatment can only be performed after the inflammation subsides.
(6) For ESWL calculus removal treatment, generally 1-3 treatment sessions are sufficient to remove the calculi, with a duration of 5-7 days. Patients in good physical condition can undergo continuous treatment, while those with poorer physical health can have treatment every other day. If patients have poor urinary function or infections, the hospitalization period may be longer. According to clinical observations, Professor Chen Bangjing believes that ESWL is the leading new technology for treating calculi domestically and internationally. It is the preferred method for treating renal calculi, ureteral calculi (ureteral calculi can generally be removed within two hours), gallstones, and extrahepatic, as well as intrahepatic. Its completely thorough calculus removal effect, lack of any organ side effects, and low cost have benefited a vast number of patients. For calculi beyond the scope of ESWL, extracorporeal shock wave lithotripsy should be performed first, followed by calculus removal. For larger renal cast calculi and gallstones, surgical removal is recommended as soon as they are detected.
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