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Ureteric stones generally happen on account of non-ideal eating regimen or metabolic issue. They are the subject of this handout which will educate you about conceivable treatment choices and prophylactic measures.

The treatment of ureteric stones to date is in all cases low-level intrusive; that implies with no open surgery. The alternatives extend from a stone fracture from outside to endoscopic, or so call “keyhole” operations.

Stone is just a side effect of the stone ailment. You can lessen the danger of stone arrangement. Contingent upon the arrangement of your stone, different prophylactic measures can be utilized.

We want to give you a handy guide through this leaflet

 

Treatment options:

Details of the treatment options described in the following may vary depending on the individual situation for each patient. Your doctor may find that one or another treatment option is better suited in your individual case. Small stones can often be passed spontaneously with the help of drugs and increased fluid intake. Physical activity will support this. Uric acid stones can be dissolved with drug therapy.

If stones cannot be passed spontaneously, your Stone Team will have the following treatment options at hand:

 

Extracorporeal Shockwave Lithotripsy.

ESWL is a minimally invasive therapy option for the treatment of ureter and ureteric stones. The urology treatment is based on the fragmentation of a stone by shockwaves. Shockwaves are created outside the patient’s body and are centered onto the stone inside the patient’s body with the help of x-ray or ultrasound imaging. The fragments are then spontaneously passed with the urine.

The advantage of this option is the non-touch stone fragmentation with a low complication rate. Normally, this can be done without general anesthetic by a Miami doctor. The patient will receive some painkillers before treatment. The duration of the treatment is in the range of about an hour.

 

Percutaneous Nephrolithotomy (PCNL)

PCNL is the endoscopic minimally-invasive removal of ureter stones by direct puncture of the affected ureter through the skin. This procedure is done under general anesthetic. The puncture is performed in the operating theater with ultrasound or x-ray guidance. The puncture canal is widened with a balloon to about 1 cm which allows us to insert thin instruments directly into the ureter which then can fragment and remove the stones.

After the operation, the ureter is usually drained for 1-2 days with a little tube coming out of the puncture site (nephrostomy) or down to the bladder with a plastic stent (JJ stent).

The advantage of PCNL is the quick and low-risk removal of larger stones from the ureter. While treatment of larger ureter stones with ESWL usually requires more than one treatment, in most cases, larger stone burdens can be removed from a ureter completely with one session of PCNL.

In principle, PCNL is a low-risk procedure.

 

Prophylactic measures with drugs

Since the above-mentioned general prophylactic measures are usually not sufficient to prevent stone formation, an additional drug therapy is needed in almost all patients. The aim of the drug therapy is to level the urinary pH to above 7.5 since the solubility of the amino acid cystine in urine significantly increases in this pH range. Also, other specific drugs can be given.

Ureteric Stones patients are particularly high-risk patients and should be followed up carefully and regularly.

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