0 5 Can ureteral stones be expelled non surgically?

Yes, ureteral stones are not large, and if there is no urinary tract obstructive lesion, drug stone expulsion can be used first**. That is, drinking plenty of water, taking stone removal drugs, moderate exercise and other methods to help the stone pass on its own, generally speaking, minimally invasive surgical intervention is not required.

The common clinical Chinese patent medicines for expelling stones include urolithiasis pills, detoxifying granules, etc. Urolithiasis pills clear away heat and dampness, clear and drain stones, used for kidney, ureter, bladder, urethral stones, can accelerate stone expulsion, especially suitable for the early stage of stone disease**. Stone removal granules are dehumidifiers, which can also ** various types of urinary stones.

In order to cooperate with stone expulsion**, patients need to drink more water (more than 3000ml per day), exercise more to promote stone excretion, and should also pay attention to eating less oxalic acid-rich foods such as spinach, celery, beans, grapes, dried figs, stone fruits, etc. Eat less foods high in calcium like soy products, animal bones, milk, soy milk, etc. In addition, protein intake should be limited daily, and meat such as beef and mutton, and animal offal should be eaten less.

Avoid smoking, alcohol and frying, barbecue food, smoke less and drink less.

In a word, not much, exercise more, drink more water, and urinate more are conducive to the discharge of stones.

Method

1. Spontaneous stone discharge, for smaller stones (diameter less than 5mm), you can promote the discharge of stones by drinking more water + Shiqi tea + exercise, generally after a period of time, most of the small stones can be discharged, if the stones are too large, the width of the stones is greater than the inner diameter of the ureter, it is not appropriate to use drugs to discharge stones, and the stones cannot pass through the ureter.

2. Extracorporeal shock wave lithotripsy, for stones of about 1cm, because their diameter is much larger than the inner diameter of the ureter, they generally cannot be discharged from the body by themselves, and it is often necessary to carry out extracorporeal shock wave lithotripsy, and the large stones are beaten into smaller stones, and they are discharged one by one by using the action of urine flow scouring. However, extracorporeal shock wave lithotripsy also has its contraindications, such as bleeding in patients with abnormal coagulation mechanisms, and extracorporeal lithotripsy in patients with arrhythmias may cause arrhythmias to worsen. In addition, repeated extracorporeal lithotripsy can lead to ureteral stricture or renal atrophy, so you must be cautious, so if you have more than 2 times of extracorporeal lithotripsy and the stone still cannot be broken, it is not suitable for extracorporeal lithotripsy;

3. Ureteroscopy, most ureteral stones can be removed from the body through ureteroscopy, especially for patients who are ineffective in extracorporeal shock wave lithotripsy, most of them can be continued by ureteroscopy. However, ureteroscopy is performed in the ureter, which may cause ureteral damage, so it should be performed with caution.

4. Percutaneous nephroscopic surgery is only suitable for large stones (more than 2cm in diameter) in the ureteral connection site or upper ureter, which are either ineffective or inefficient with other methods. Percutaneous nephroscopy is performed with an eye on the kidney, which has some renal damage. Therefore, the indication is not as broad as that of ureteroscopy.

Your condition depends on the volume of ureteral stones and should be performed with ureteroscopy**.

Patients with ureteral stones should eat more fresh vegetables and fruits, and should not eat high-purine foods, such as animal offal, spinach, various beans, cauliflower, seafood, etc. Drinking, especially beer, can increase uric acid levels and cause urine concentration, so it should not be consumed; Excessive intake of animal protein can lead to an increase in urinary calcium and uric acid and a decrease in citrate, which is an important factor in the formation of urolithiasis. Therefore, the daily diet should be mainly vegetarian, and eat more fiber-rich foods.

It can be discharged through drugs, with more water and exercise, and for some relatively large stones, extracorporeal shock wave lithotripsy can be done to break large stones into small ones, and then discharge them through this ureter and bladder. Lin Bao Pharmaceutical's Stone Draining Oral Solution, you can learn about it, specializing in the treatment of stones.

If the diagnosis is a faint stone at the end of the right ureter, extracorporeal lithotripsy is more difficult because it is difficult to locate. (Of course, an experienced doctor can also break it). It is recommended to give infusions, drink plenty of water, jump appropriately, and then use some drugs to expel stones, and maybe you can come out.

If this is not possible, it needs to be broken with a ureteroscope to rule it out. In short, it is necessary to deal with it quickly, otherwise it is easy to cause hydronephrosis.

Beijing ****-Department of Urology-Chief Physician Shi Bingbing.

Surgery should be considered for patients who have affected renal function due to urinary flow obstruction caused by stones, or who have not been ineffective by non-surgery** and do not have extracorporeal shock wave lithotripsy conditions. You can drink the tea of Yujiao, which is diuretic and can safely expel stones.

Preoperative preparation: It is necessary to understand the bilateral renal function before surgery, and the infection must be controlled with antibiotics first. Patients with ureteral stones should take plain radiographs of the urinary tract before entering the operating room or on the operating table for the final positioning of the stones.

Surgical methods: Depending on the size, shape and location of the stone, the following surgical methods are commonly used:

1 Renal pelvis or sinus incision and stone removal: incision of the renal pelvis, removal of stones, antler stones or calyceal stones, sometimes it is necessary to perform intrasinus pelvis calyceal incision and stone removal.

2. Renal parenchymal incision and stone removal: If the kidney stone is large and cannot be incised through the renal sinus, the renal parenchyma needs to be incised and removed.

3 Partial nephrectomy: It is suitable for multiple stones at the first pole of the kidney (mostly at the lower pole of the kidney), or in the dilated and poorly drained calyce, and the first pole of the kidney or the calyces can be removed together with the stones.

4 Nephrectomy: One side of the kidney stone and severe hydronephrosis or pyomeria, which has caused serious damage or loss of kidney function, and the opposite kidney function is good, the affected kidney can be removed.

5 Ureterotomy and stone removal: ureteral stone diameter is greater than 1 cm or stone incarceration causes urinary flow obstruction or infection, and ureterotomy can be used for non-surgical ** ineffective patients.

6 Stone set: The diameter of the middle and lower ureteral stones is less than centimeters, and it can be tried with a special basket or catheter sleeve through cystoscopy.

7.After surgery, you can drink healed tea to help prevent **.

Ureteral stones above 1cm are relatively large, you can consider taking extracorporeal shock wave lithotripsy**, after the stones are broken, then take stone excretion drugs to promote the discharge of lithotripsy, and use healed stone tom tea diuretic stone excretion.

Patients need to be aware of the following after extracorporeal shock wave lithotripsy:

1) Drink plenty of water. This method is very important and very effective. The amount of water to drink is generally more than 3000ml per day.

2) Exercise more. Do more jumping and running up and down exercises to make it easier for stones to be discharged.

3) Insist on taking medications that pass stones. Among the commonly used clinical expulsion stones, Chengqin Jing Yao Shenyuan has urolithiasis pills, stone expulsion granules, etc., which can promote the discharge of stones as soon as possible, and should be taken according to the course of treatment. For example, urolithiasis pills are a routine medicine for stone removal after various lithotripsy surgeries, which can accelerate stone expulsion, reduce complications, and also have a preventive effect on stone surgery.

4) Eat less oxalic acid-rich foods. Such as spinach, celery, beans, beets, celery, green peppers, coriander, grapes, dried figs, stone fruits, etc.

5) Eat less foods that are high in calcium. For example, soy products, animal bones, milk, soy milk, etc. should also be drunk in moderation.

6) Limit protein intake. Intake of beef, lamb and other meats, organ meats, etc., should be limited.

7) Avoid smoking, alcohol and fried and barbecued foods.

Such a large stone does not require surgery, and if the stone is in the kidney, you can consider taking medicine to dissolve the stone to promote the discharge of the stone into the ureter, if it cannot be discharged on its own, cooperate with lithotripsy**. If the stone is in the ureter, lithotripsy can be taken directly with medication to promote stone excretion. However, if the stone stays in a certain part of the ureter for a long time, causing adhesions, and the lithotripsy cannot solve the problem, it is necessary to remove the stone under the microscope.

Hello teacher, based on your description, suggest the following.

1. The purpose of routine placement of stent tubes after ureteral stone removal is to expand the ureter, and after the ureters are enlarged, the kidney stones and residual small stones can easily slide into the bladder through the ureter. The second is to drain urine and relieve kidney function. The third is to prevent the damage to the ureteral mucosa caused by ureteral stone removal and ureteral scar stenosis.

2. According to the teacher's statement, the waist pain began to occur half a month after the stent tube was placed, mainly considering that the teacher had small stones in the kidney, which fell into the ureter and caused pain. The second cause of pain is the reflux of the bladder ureteral orifice caused by the teacher when urinating after the stent tube is placed.

Long-term drinking of traditional Chinese medicine can be discharged if the syndrome differentiation is accurate and the drug compatibility is reasonable, but the stone is larger, it takes a long time, and it is also easy to be concurrent with wrapping adhesions, this situation can be used with extracorporeal lithotripsy, it is not recommended to consider ureteroscopy first, generally after taking traditional Chinese medicine to discharge stones quickly, and there is no ***, remember to be anti-inflammatory for three days after lithotripsy, if the stone has been wrapped and adhesion, consider using ureteroscopy.

The ** of the stone needs to be based on the size, nature and location of the stone**. Your current stones are still relatively small, but if you simply take medicine and drink a lot of water to let the stones pass on their own, it is still a little dangerous, because the stones are often easy to block when they reach the ureteral stricture, and the chance of recurrence is also relatively large. In this case, the body can be regulated as a whole, improve the pathological environment of the kidneys, and gradually shrink, discharge or even disappear the stones through traditional Chinese medicine to dissolve stones, fossils, and excretions.

Protecting and repairing the environment in the kidneys while expelling stones can also prevent stone regrowth in the future. Pay attention to your diet and do more exercise, I wish you a speedy **.

Exercise more, drink more water, you don't need to go to gravel, gravel will not outweigh the losses. The principle is the same as fighting mosquitoes with anti-aircraft guns. The shock wave is also energy, and it is more suitable to hit 1-2cm stones, 5mm is too small.

Suggestion, the suggestion is that when the stones go down, they may be stuck and cause renal colic, and when the pain is painful, go to the hospital for injections and hanging water. The rest, you know: drink plenty of water.

Hope it helps you a little. ◇

Hello, it is recommended to extracorporeal ultrasound lithotripsy, combined with traditional Chinese medicine to drain stone decoction**.