What should I do for infected upper urinary tract stones?

  Infectious upper urinary tract stones are generally defined as deerstalker-type stones in the kidney, or ureteral stones with severe obstruction and significant hydronephrosis, often accompanied by a history of recurrent urinary tract infections, with pus and white blood cells visible in urinalysis and pathogenic bacteria such as E. coli and S. pyogenes found in urine culture. These pathogenic bacteria are hiding inside these stones or even at the core of the stones, and it is generally difficult for antibacterial drugs to reach these places to kill them. After stopping the antimicrobial drugs, the bacteria inside the stones can resurface and cause urinary tract infections again. If there are stones left after surgery, urinary tract infection and urinary tract stones are factors that promote each other. Infection can cause kidney stones, and stone obstruction can aggravate the infection, thus making the stones bigger and bigger and forming deerstalker stones again, creating a vicious cycle that eventually leads to impaired kidney function. Controlling urinary tract infection and relieving urinary tract obstruction are the main purposes for protecting the kidney function of patients with urinary tract stones.  1. General treatment: By drinking 2000~3000ml of water daily to increase urine discharge, the growth of stones can be prevented. Especially drinking water before bedtime can prevent urine concentration and crystalline precipitation from forming stones at night. Drinking a lot of water can also make the bacteria in the urine to be discharged in large quantities, which is conducive to the control of infection.  2, the use of antibacterial drugs: usually use antibacterial drugs sensitive to bacteria, the empirical use of drugs are generally quinolones. For patients with complicated infected urinary tract stones, a mid-stage urine culture can be performed first, and then the drug sensitivity test can be used to determine which drug to use. The use of antimicrobial drugs before surgery plays an important role in the prevention of intraoperative and postoperative bacteremia and sepsis.  3, symptomatic treatment: renal colic attack, you can use antispasmodic and analgesic symptomatic treatment. Large amounts of fluid can be supplemented.  4.Surgical treatment: For most of the stones, they can be removed by minimally invasive surgery to crush the stones. Such as PCNL surgery, ureteroscopic lithotripsy, etc. General preoperative urine culture, preoperative preventive use of antibacterial drugs, postoperative to keep the urine drainage and use of antibacterial drugs.