What Is Ureterolithiasis?
The clinical manifestations of ureteral stones are similar to those of kidney stones.
- Western Medicine Name
- Ureteral stones
- Affiliated Department
- Surgery-urology
- Disease site
- ureter
- Contagious
- Non-contagious
| Wang Gang | (Deputy Chief Physician) | Department of Urology, Peking University First Hospital |
| Zhang Xiaochun | (Chief physician) | Department of Urology, Peking University First Hospital |
- Ureteral stones are usually caused by renal stones being temporarily blocked in the ureteral stenosis during discharge. Primary ureteral stones are rare. If the ureteral stones are not discharged, they may grow gradually at the staying site. Ureteral stones are usually accompanied by obvious symptoms, such as renal colic, hematuria, and ureteral stones often cause obstruction and hydronephrosis, all of which require emergency treatment.
Clinical manifestations of ureteral stones
- The clinical manifestations of ureteral stones are similar to those of kidney stones.
Ureteral calculi
- Young adults are a high-risk group: the peak age of onset is 20-50 years old, that is, it occurs in the labor force who is just in the middle of adulthood, and males are two to three times as many as females.
Ureteral stones
- (1) Colic in the waist: Renal colic is a typical symptom of ureteral stones. Usually, severe pain in one side of the lower back occurs suddenly after exercise or at night, because it is too painful. It is often described as "knife-like", and the lower abdomen can appear And pain in the inner thigh, nausea and vomiting, pale complexion, etc. The patient was restless and very distressed. Some patients present with lumbar pain and tenderness. After pain, some patients can find stones that urinate.
- (2) Hematuria: About 80% of patients develop hematuria, and only a part of them can see that the urine is red, and most of them can only be found by testing urine.
- (3) Asymptomatic: Many patients stumbled upon ureteral stones during physical examination without any symptoms.
- (4) Hydronephrosis: stones block the ureter, and urine is not discharged smoothly, causing hydronephrosis. Some hydronephrosis can be without any symptoms. Prolonged hydronephrosis can cause impaired renal function. Severe bilateral hydronephrosis may cause uremia.
- (5) Fever: ureteral stones can also induce bacterial infections, leading to kidney empyema and high fever. Because the stones hinder the excretion of urine, the bacteria cannot be excreted in time. In severe cases, it can cause sepsis and be life-threatening.
Differential diagnosis of ureteral stones
Diagnosis of ureteral stones
- X-rays of the urinary system can be used as a preliminary examination method for ureteral stones. About 10% of ureteral stones are not developed. Because most of the ureters are blocked by the intestines and bones, B-mode ultrasound can usually only detect the upper ureter, so B-mode ultrasound is not a good way to diagnose ureteral stones. The diagnosis of ureteral calculi requires CT and intravenous urography (IVU).
Differential diagnosis of ureteral stones
- When renal colic occurs, it needs to be distinguished from cholecystitis, appendicitis, intestinal obstruction, ureteral stenosis, ureteral tumors, etc .; abdominal calcification points need to identify gallbladder stones, lymph node calcification, renal tuberculosis, pelvic vein stones, etc.
First aid measures for ureteral stones
- In the following cases, you need to go to the hospital for emergency treatment as soon as possible.
- (1) Renal colic: given antispasmodic and analgesic treatment.
- (2) Infection with high fever: antibiotics and antipyretic treatment are given. It is more important to drain the kidney's pus as soon as possible by placing a ureteral stent or renal puncture fistula.
- (3) Anuria: If uremia has occurred and the body is in critical condition, dialysis treatment is needed. If the condition is stable, a ureteral stent or renal puncture fistula needs to be temporarily drained to protect renal function.
Treatment of ureteral stones
- Ureteral stones are likely to cause ureteral obstruction and should be actively treated.
- Usually less than 5mm of ureteral stones, 80% to 90% can be discharged within 6 weeks, so conservative treatment is generally selected. You can take traditional Chinese medicine for rowing stones, antispasmodic and analgesic drugs, and ureteral relaxation drugs.
- According to the "Guidelines for the Diagnosis and Treatment of Urinary Stones" of the Urological Surgery Branch of the Chinese Medical Association, ureteral stones larger than 5mm can be selected from external lithotripsy or ureteroscopy. In general, stones in the upper part of the ureter have a better effect on lithotripsy; stones in the middle and lower part of the ureter have a greater degree of ureteroscopy. If the ureteral stone is too large, external lithotripsy or ureteroscopic treatment fails, you can choose to cut the stone.
- After treatment, be sure to conduct a review to ensure that "there is no way out." [1-4]