A small ureteral stone, does it have a big impact?
Aunt Liu, 57, was suddenly critically ill. Thanks to the timely rescue of a urologist, she could be successfully rescued from the “ghost of death”. However, Aunt Liu and her family never imagined that what almost killed her was a small ureteral stone.
A few days ago, Aunt Liu, who lives in a small mountain village, suddenly developed chills, chills, and shivering. When she checked her temperature at home, it was 39.3°C, thinking it was I caught a cold, so I took cefixime and antipyretics at home. After sweating, Aunt Liu’s body temperature returned to normal, so she didn’t pay attention.
Unexpectedly, the next day, Aunt Liu was woken up by pain. Not only did the symptoms of fever and fear of cold appear again, but also the pain in the left waist was severe. The whole person was groggy and lay on the bed. don’t want to get up. She hurriedly called her son, and her family drove her to the local Municipal People’s Hospital for treatment.
After arriving at the hospital, a body temperature has reached 40°C! The doctor ordered her to be hospitalized immediately, and the systolic blood pressure was measured to be <90mmHg. Auxiliary examinations showed that Aunt Liu's white blood cells and neutrophils were significantly increased. Color Doppler ultrasound showed that her left kidney had severe hydrops, accompanied by kidney and ureter stones. The stone got stuck in the lower part of the left ureter, and finally caused sepsis with septic shock!
Source: Tencent Medical Illustrator
How do ureteral stones happen?
Urinary calculi is one of the common and frequently-occurring diseases in urology, of which kidney stones are the most common. The vast majority of ureteral stones are the “passing” of the ureter when the kidney stone is discharged, just stuck in the narrow part.
Urinary stone formation is related to the following reasons:
Changes in the physicochemical properties of human urine, when the concentration of crystal substances in urine is normal but the physicochemical properties of urine change, it can promote the formation of urinary calculi; The change of the physicochemical properties of the fluid and the high concentration of crystal substances in the urine lead to the saturation of the urine, which is the most important reason for the formation of urinary calculi;
Reduced urine output: increases the concentration of salts and organic matter;
Stones will not cause back pain and discomfort when the patient’s ureter is not blocked. Even if the ureteral stone blocks the ureter and causes hydronephrosis, it is often a slow progression process, and the human body will gradually adapt to it. During this process, there will be no severe pain.
The increase in the concentration of crystal substances in human urine leads to an increase in the excretion of crystals from the body and an increase in the concentration of urine crystals.
Image source: Zhanku Hailuo
How can a small stone have such serious consequences?
In the story of Aunt Liu at the beginning, the main problem is that her ureteral calculi caused upper urinary tract obstruction, urine could not be effectively and timely discharged, resulting in left Lateral hydronephrosis.
Furthermore, as hydronephrosis becomes more and more serious, kidney function is also severely damaged, and the metabolites in the body are difficult to be excreted through the kidneys, causing bacterial infection.
In addition, Aunt Liu suffers from coronary heart disease and diabetes, and her own resistance is poor, so she is prone to urinary tract infections. Elderly patients, on the other hand, are generally indifferent to the disease, and always want to procrastinate.
But delaying treatment is undoubtedly very dangerous. Over time, it aggravates the systemic inflammatory response, triggers septic shock, and leads to urosepticemia, which can be life-threatening at any time.
Source: Tencent Medical Illustrator
Finally, the doctor uses a ureteroscope for intubation and drainage to drain the pus from the body, completely remove toxins from the body, and remove the stones. Aunt Liu finally passed the critical period and has now been discharged from the hospital to recuperate at home.
Statistics show that the fatality rate of sepsis is still as high as 30% to 70%[1], of which sepsis caused by urinary calculi accounts for about 25%. So, bigGuys, don’t underestimate that small urinary tract stone, it can be life-threatening in severe cases.
I have stones, what should I do?
I also remind everyone here that must pay attention to daily health checkup. Once urinary calculi are detected, scientific and active treatment should be carried out. Request regular review of urinary system color Doppler ultrasound. If there is severe pain in the lower back, accompanied by symptoms such as nausea and vomiting, you must go to the hospital immediately. The doctor will first prescribe painkillers for antispasmodic and pain relief treatment.
Regardless of the composition of urinary stones, most of them can be excreted by themselves as long as they are smooth stones less than 0.4cm in diameter.
The diameter of the stone is 0.4-0.6cm, or some stones up to 1.0cm. If the surface is smooth and there is no symptoms of hydronephrosis or urinary tract infection, drug expulsion therapy can be used In clinical practice, potassium and sodium citrate granules and antispasmodic and analgesic drugs are often used to dilate the ureter, and then by drinking plenty of water and urinating regularly, it is possible to excrete the stones.
At the same time, you can also try rope skipping. With the frequent vibration of the body up and down, ureteral stones may slowly come out along the ureter.
Image source: Zhanku Hailuo
So, what kind of ureteral stones require surgery?
It is generally believed that stones larger than 1.0cm in diameter have less chance of self-discharging, especially common oxalic acid stones, which are difficult to discharge due to their rough surface. Surgical treatment should be considered if the obstruction caused by the stone affects renal function, or if non-surgical treatment fails.
For the prevention of urinary calculi, it is recommended to drink more water in daily life, go to the toilet on time, urinate regularly, ensure that the urine volume is more than 2500ml per day, and avoid overeating .
Different types of stones require different dietary prevention methods.
Uric acid stones should adopt a low purine diet in life, and cystine stones should adopt a low methionine diet in life.
Fruits and vegetables can make urine more alkaline, which is better for preventing uric acid and cystine stones.
Foods like beef and mutton make urine acidic, which is good for preventing infection.
As for oxalic acid stones, you need to eat less food rich in oxalic acid, such as cabbage, bamboo shoots, spinach and other vegetables.
Image source: Zhanku Hailuo
References:
[1] Yao Yongming, Sheng Zhiyong. Sepsis Prevention. Science and Technology Literature Publishing House, 2008
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