A Urinary stone is a debilitating event in the life of usually a young person. The presentation can be acute and very painful requiring emergency care. This can be managed conservatively unless there is uncontrolled pain and/or sepsis.
Pain is perceived when the offending stone is moving or obstructing the lumen of the ureter. Pain is colicky and radiating from loin to groin. There may be associated nausea, vomiting, haematuria (blood in the urine), GI symptoms as nausea/vomiting and even constitutional symptoms as fever and rigors indicating sepsis.
Treatment is to be personalised based on patient and stone characters but diagnosis, pain relief, prevention of infection and bypassing the obstruction are primary outcomes in the emergency setting. Depending on various characters of the stone such as size, shape, location further treatment can be planned to include type of surgery if that is indicated.
Typically, a DJ stent is inserted in emergency to bypass the obstruction and stabilise patient till a definitive surgical procedure is performed under elective setting.
Stents can also give rise to significant intolerable symptoms as dysuria, hematuria, loin pain and symptoms can be quite significant and disabling.
Indwelling stents left in longer than needed themselves can cause infection and promote further stone formation and should be left in the patient only for as long as required.
Effective management includes urgent and precise diagnosis using appropriate imaging and instituting definitive management timely. Usually a disease of the young patient we aim to try and reduce the ‘sick’ period and offer urgent treatment in a timely fashion to bring the episode to a successful completion.
We specialise in management of all types of renal/ureteric/bladder stones and use modern state of the art medical equipment to achieve a high success rate.
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