Patient's question:
Last week, I was taken to the hospital due to severe abdominal pain. The doctor examined me and said I had ureteral stones. They recommended a stone fragmentation surgery, saying that as long as the stones were passed out, everything would be fine. However, during this process, I was also given progesterone. Why was I given progesterone?Doctor's answer:
Hello:Ureteral calculus, the use of progesterone is to dilate the smooth muscle of the ureter to assist in stone expulsion. It is recommended to first choose extracorporeal shock wave lithotripsy (ESWL) for stone removal treatment; and to start early treatment as soon as possible, as the effect is better.
First, let me explain that extracorporeal shock wave lithotripsy (ESWL) is a non-invasive, new type of stone removal treatment device and technology. Its principle is entirely different from that of extracorporeal shockwave lithotripsy. The advantage of ESWL lies in its lack of organ damage, thorough stone removal, minimal pain for patients, and easy acceptance. In contrast, extracorporeal shockwave lithotripsy causes organ damage and is more painful.
The ESWL technology employs high-frequency superconducting fluid dynamic shock wave three-dimensional integrated lithotripsy technology, assisted by large digital ultrasound for positioning. It features accurate positioning, rapid stone removal, and is particularly effective for bile duct stones, ureteral stones, allowing stones to be removed as they move. It is especially effective for removing stones from intrahepatic bile ducts. The most prominent feature of this equipment is its user-friendly operability, thorough stone removal for various types of stones, wide applicability, minimal side effects on the human body, painless stone removal during the process, no need for hospitalization, and low treatment costs, making it easily accepted by 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 choice for renal and ureteral stones under 10mm. Generally, after several treatments, stones can be removed. For larger stones, the principle of first crushing and then removing is adopted to achieve complementary advantages. However, for ureteral stones, treatment must be delayed by 3-5 days after the local ureter congestion and edema subside before stone removal. 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 are usually detected early, providing the best conditions and timing for ESWL treatment. For stones that have been lodged in the ureter for a long time, it is difficult to remove them and may require surgical or ureteroscopic lithotripsy. At the same time, it is more important to provide patients with the latest measures for early stone removal to avoid excessive treatment methods that cause significant organ damage, poor efficacy, pain, and high costs.
The indications and scope of treatment for ESWL are as follows:
(1) For various renal and ureteral stones less than 1.2 cm in diameter, ESWL should be the first choice for stone removal. This is because it causes no kidney damage, ensures thorough stone removal, is safe and painless, and avoids the side effects of shockwave lithotripsy. If the stone diameter exceeds 1.2 cm, extracorporeal shockwave lithotripsy should be used first to crush the stone, followed by ESWL for thorough stone removal, achieving complementary advantages.
(2) This equipment is particularly suitable for acute ureteral stones and the resulting hydronephrosis, renal pelvis dilation, ureteral hydronephrosis, ureteral dilation, and renal colic. It can quickly remove ureteral stones, relieve immediate pain, and rapidly alleviate symptoms, making it the preferred treatment for ureteral stones.
(3) For patients with multiple renal stones on the same side combined with ureteral stones, the ureteral stones should be removed first, followed by the removal of multiple renal stones, to prevent the formation of a "stone street" in the ureter.
(4) For large renal stones, after ESWL fragmentation, small residual stones in the lower pole of the kidney, renal pelvis, or calyces are the best candidates for ESWL for thorough stone removal. This is because the handheld high-frequency superconducting shock wave transducer can directly touch the lower pole renal stones, allowing them to move into the renal pelvis and ureter for removal.
(5) For the stone removal treatment of the above types of stone diseases, if complications such as urinary tract infections lead to pyelonephritis, ureteritis, cystitis, prostatitis, or urethritis, the stone removal process may be hindered due to mucosal inflammation, congestion, and swelling. Therefore, antibiotic anti-inflammatory treatment must be administered first, and ESWL treatment can only be performed after the inflammation subsides.
(6) Generally, 1-3 ESWL treatments are sufficient to remove stones, with a duration of 5-7 days. Patients in good physical condition can undergo continuous treatments, while those with poorer physical health can have treatments 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 currently the leading new technology for treating stones domestically and internationally. It is the preferred method for treating renal, ureteral (ureteral stones are usually removed within two hours), gallbladder, and extrahepatic bile duct stones, as well as intrahepatic bile duct stones. Its completely thorough stone removal effect, lack of organ side effects, and low cost have benefited a vast number of patients.
For stones beyond the scope of ESWL, extracorporeal shockwave lithotripsy should be performed first, followed by stone removal. For large renal 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.