Patient's question:
There is a 5.6mm urinary calculus at the bladder orifice. Which treatment method is better?Doctor's answer:
Hello: Ureteral terminal calculus, 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; they typically present with lower back pain, discomfort, and severe renal colic. 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 the 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 ESWL is a non-invasive, new type of stone removal treatment device and technology. Its principle is entirely different from that of extracorporeal shock wave lithotripsy (ESWL). The advantage of ESWL lies in its lack of organ damage, thorough stone removal, minimal patient pain, and easy acceptance. In contrast, extracorporeal shock wave lithotripsy (ESWL) causes organ damage and is more painful.
The ESWL technology employs high-frequency superconducting fluid dynamic shock wave lithotripsy, a three-dimensional integrated technology assisted by large digital ultrasound for positioning. It features accurate positioning, fast stone removal, and complete removal of bile duct stones and ureteral stones, especially effective for intrahepatic calculi and. The most prominent feature of this device is its humanized operability, thorough stone removal for various types of stones, wide applicability, minimal side effects on the human body, painless stone removal 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 kidney and ureteral stones under 10mm. Generally, after several treatments, stones can be completely 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 to allow local ureteral congestion and edema to subside before stone removal. Generally, stones are relatively easy to remove. With the widespread use of ultrasound, the diagnosis of ureteral stones is more timely and easier. 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 without surgical or ureteroscopy procedures. 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 kidney and ureteral stones less than 1.2cm, ESWL should be the first choice for stone removal treatment. This is because it causes no kidney damage, ensures thorough stone removal, is safe and painless, and avoids the side effects of shock wave lithotripsy. If the stone diameter exceeds 1.2cm, extracorporeal shock wave lithotripsy should be used first to crush the stone, followed by ESWL for thorough stone removal, achieving complementary advantages.
(2) This device is particularly suitable for acute ureteral stones and the resulting renal pelvis 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 kidney stones on the same side accompanied by 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, after ESWL, small residual stones in the lower pole of the kidney, renal pelvis, or calyces are the best candidates for ESWL stone removal. This is because the handheld high-frequency superconducting shock wave can directly touch the lower pole kidney stones, allowing them to move into the renal pelvis and ureter for removal.
(5) For the stone removal treatment of the above types of stones, if complications such as urinary tract infections lead to pyelonephritis, ureteritis, cystitis, prostatitis, or urethritis, and if inflammatory congestion and swelling of the mucosa affect stone removal, antibiotics must be administered first to treat inflammation before ESWL stone removal.
(6) For ESWL stone removal treatment, generally 1-3 treatments are sufficient to completely 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 once 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 stones domestically and internationally. It is the preferred method for treating kidney stones, ureteral stones (which are usually removed within two hours), gallstones, and extrahepatic bile duct stones. With its completely thorough stone removal effect, no organ damage, and low cost, it benefits a vast number of patients. For stones beyond the scope of ESWL, extracorporeal shock wave lithotripsy should be used first to crush the stones, followed by removal. For large kidney cast stones and gallstones, surgical stone removal is recommended as soon as they are detected.
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