The incidence of urinary stones in China ranges from 1% to 5%, and up to 5% to 10% in the south, making it one of the three most prevalent stone areas in the world. Because of the high incidence and recurrence rate, China has accumulated a lot of experience in the treatment of urinary stones. However, nowadays, various kinds of lithotripsy tea, lithotripsy oral solution and lithotripsy treatment devices are widely advertised as “no-incision lithotripsy” and “green treatment, painless and residue-free”. Are these methods harmful? What is the real reliable method? Are “miracle cures” reliable for removing urinary stones? Case 1: Ancestral stone removal soup, may damage kidney function Nowadays, there are various Chinese medicine stone removal soup and lithotripsy oral solution on the market, commonly used Chinese medicine such as money plant and psyllium, etc. The main purpose is to increase the volume of urine, flush the stones and promote the movement of stone removal; on the other hand, increase the peristalsis of ureteral smooth muscle, which is conducive to the discharge of fallen stones through the stricture. The composition of urinary stones is mostly calcium oxalate, followed by phosphate, urate and carbonate. Based on the composition of stones, it can be inferred that it is difficult to dissolve urinary stones by herbal medicine alone, and that herbal stone removal therapy is not applicable to all urinary stones. When stones are too large and fall into the pelvic orifice or the ureteral junction of the renal pelvis, they can cause urinary obstruction. If the urine volume increases dramatically for a short time, it will aggravate the obstruction symptoms, causing severe pain, hydronephrosis, and damage to kidney function, and long-term hydronephrosis will also cause kidney failure. Case two: drinking water and jumping rope is not “a panacea” We often hear neighbors say drinking water and jumping rope can discharge stones. In fact, the method of drinking water and skipping rope is only applicable to small asymptomatic kidney stones less than 0.6 cm, and this method mainly uses the effect of gravity to promote the discharge of stones from the kidney. However, this method is not a panacea, so you need to be very careful when choosing it. If the diameter of the stone is larger than the diameter of the renal pelvis or ureter, accidentally moving the stone to the mouth of the renal pelvis or sliding down into the ureter to form an obstruction will cause hydronephrosis, which will lead to kidney failure and even uremia over time. Case 3: Inverted “stone bed”, not so magical A news article from Xinhua News Agency mentioned that a farmer in Jiangxi made his own “stone bed” to save his sick wife, and also obtained a national patent. Theoretically this is only effective for kidney stones in the lower calyx, it turns the person upside down and promotes the discharge of small stones out of the body. There are many structures like small rivers in the kidneys called ‘calyces’. The urine formed in the kidneys converges from each calyx to the renal pelvis and is finally transported to the ureter and bladder. According to the location of kidney stones in the kidney, they are divided into upper calyx stones, middle calyx stones and lower calyx stones. Small stones in the upper and middle calyces are easier to fall down than stones in the lower calyces because the body is upright, and small stones in the lower calyces are easier to fall into the renal pelvis and out of the body only when the body is upside down. Back to the news, regardless of whether it is uncomfortable to turn a person upside down, this “stone bed” is only theoretically applicable to small stones in the lower calyces of the kidney, and is not effective for stones that are too large or located in the middle or upper calyces. Both prevention and treatment should be grasped 1. Increase water consumption and dilute urine When we urinate, we will find that if we drink more water, the color of urine is clear and bright, if we drink less water, the color of urine will be yellow. If you drink too little water, the urine will be oversaturated, leading to stone formation. It is generally recommended that a normal person should have a daily fluid intake of 2,5 to 3 L and a urine volume of 2 to 2,5 L. It is appropriate to keep the urine color clear and light yellow. However, people with poor kidney function and heart function should pay attention to drinking water in moderation and not in excess. 2. Adjust the diet structure Change the bad eating habits, eat less high-fat food, and increase the intake of fruits and vegetables appropriately. If you have suffered from urinary stones in the past, you should change your diet according to the composition of the stones and according to your doctor’s opinion. 3, maintain a good state of mind, increase exercise appropriately After exercise, if too much water is lost, you should replenish water in time, do not wait until you feel thirsty before remembering to drink water. 4. Stone composition analysis, guidance to prevent recurrence People who have already suffered from urinary stones can have their stones analyzed according to the stones that have been discharged or surgically removed, so as to clarify their composition and develop effective preventive measures. For example: uric acid stones are the product of disordered purine metabolism in the body, which can be prevented by alkalinizing urine, eating less animal offal, seafood, limiting high-protein foods, and drinking less beer; patients with infectious stones should control urinary tract infections; patients with calcium oxalate stones should eat less oxalic acid-rich foods such as spinach, parsley, peanuts, and black tea; patients with calcium phosphate or phosphate stones should eat less egg yolk, beans, and milk . If urinary stones are caused by other diseases, such as hyperparathyroidism and urinary tract obstruction, they should be treated at the same time to avoid recurrence of stones. 6. Regular medical checkups for early detection and treatment It is recommended to receive an annual urinary B-ultrasound to detect the presence of stones. For patients who have had stones in the past, a follow-up ultrasound and routine urine examination should be performed at least once every six months to see if the stones continue to grow, if there are any changes in their location, and if there are any urinary tract infections that increase the occurrence of stones. Urinary stones should be treated by the “regular army”. Depending on the location and size of urinary stones, the method of stone extraction is completely different. At present, the main treatment methods for urolithiasis are as follows: 1. Drug therapy Drug therapy is mainly to increase fluid intake, increase urine volume; control infection; promote ureteral peristalsis, accelerate stone discharge. The treatment is mainly to increase fluid intake, increase urine output, control infection, promote ureteral peristalsis, and accelerate the discharge of stones. Extracorporeal shock wave lithotripsy is mainly used for kidney and upper ureteral stones less than 2 or 5 cm. When the size of stones is too large, multiple lithotripsy is required, which results in long stone removal time and high stone residual rate. In addition, people with bleeding disorders, infections, pacemakers, severe cardiovascular disease, urinary tract obstruction and pregnant women are not suitable for extracorporeal shock wave lithotripsy. Frequent extracorporeal lithotripsy within a short period of time is likely to cause kidney function damage, and the interval between lithotripsy must be greater than one week. Ureteroscopic lithotripsy Ureteroscopy is the application of a small ureteroscope inserted through the urethra into the bladder, and then up into the ureter, under direct vision for lithotripsy. This method is mainly used for stones in the middle and lower ureter. The emerging ureteroscope can also be used for some patients with kidney stones. Patients with urinary tract strictures and severe distortions should not be used. 4. Percutaneous nephrolithotomy This method is performed by making a small hole of about 0.6 cm in diameter in the patient’s lumbar region to create a channel between the skin and the kidney, then a chopstick-thick endoscope is inserted into the stone site of the kidney, and finally the stone is broken and removed. Percutaneous nephrolithotomy can be applied even if the stone is large, such as antler-shaped stone, and is the most widely used minimally invasive surgical method to treat kidney stones. Laparoscopic ureteral stone retrieval is mainly suitable for ureteral stones larger than 2 cm that were originally considered for open surgery. Laparoscopic ureteral stone extraction has gradually replaced open ureteral stone extraction and is an optional surgical method. However, there are complications such as more expensive surgery, postoperative leakage and stricture. 6. Open surgery treatment Because open surgery can cause more trauma to patients, it is less used now.