Principles of standardized scientific treatment of urinary stones

The treatment of urinary stones, which have a high clinical incidence, can be minimally invasive, including lithotripsy, extracorporeal shock wave lithotripsy, percutaneous nephrolithotripsy, ureteral lithotripsy with rigid or flexible scopes and laparoscopic incision and extraction, etc. The choice depends on the location of the stone, its size (degree of fluid retention) and its composition. The choice depends mainly on the location of the stone, its size, its impact on the kidneys (degree of fluid retention in the kidneys) and the composition of the stone. Therefore, it is necessary to choose the appropriate scientific standardized minimally invasive treatment method according to the individualized characteristics of the patient’s stones. 1.Urological stone removal indications that can be conservatively treated conditions: stones less than 6mm, smooth surface, the urinary tract below the stone is smooth and no stenosis, and did not cause significant hydronephrosis and dilatation of the upper urinary tract, as well as the local residence time is less than 2 weeks. 2, Extracorporeal shock wave lithotripsy indications All patients must be free of obvious hydronephrosis and upper urinary tract dilatation. (1): Kidney stones: 1) less than 1cm renal pelvis, upper middle calyceal stones 2) greater than 1cm in diameter, less than 2cm renal pelvis, upper middle calyceal stones, the requirement of its CT value of less than 1,000, 3) less than 1cm of lower calyceal stones (2) Ureteral stones: Upper ureteral stones less than 1cm is preferred; lower middle section of the ureter is optional for less than 1cm, greater than 1cm is preferred ureteroscopy lithotripsy. Extracorporeal shock wave lithotripsy is minimally invasive, but by no means harmless, intraoperative renal parenchyma and ureteral damage can occur, so the recommended number of extracorporeal shock wave lithotripsy treatment is not more than 2 times. The interval should be 10~14 days. 3, ureteroscopy lithotripsy indications (1) ureteroscopic lithotripsy indications: ureteral stones in the lower and middle ureter less than 1cm can be selected extracorporeal lithotripsy or ureteroscopy, ureteroscopy is preferred to more than 1cm. (2) Ureteral lithotripsy indications: extracorporeal shock wave is difficult to deal with (difficult to locate, X-ray negative) the upper ureter, renal pelvis, upper calyx or middle calyx is less than 1.5cm stones or lower calyx is less than 2cm stones. Indications for percutaneous nephrolithotripsy: complete or incomplete staghorn-like stones, renal stones larger than 2cm, symptomatic renal calyx or diverticulum stones, stones with poor extracorporeal shock wave treatment. Ureteral stones above the upper edge of the fourth lumbar vertebra, with heavy obstruction or larger than 1.5cm, or ureteral stones that have failed extracorporeal shock wave lithotripsy or ureteroscopy.